Readers' Forum: The Emperor's New Clothes: surgical scrubs

Abstract

The wearing of restricted attire (surgical scrubs) outside restricted areas continues to be a concern for the infection control team, other staff, visitors and patients at many hospitals. There is a widely held perception by many visitors and health care workers (HCWs) that, when this attire is worn outside restricted areas, discipline and infection control practices may not be of an acceptable standard. This issue is contentious as many HCWs in restricted areas feel that what they wear should not be a concern for 'outsiders'. There is also no evidence to show what they are doing (or not doing) will be associated with health-care associated infections. This article has been written in an attempt to address the issue. It is opinion based and meant to be thought provoking. The objective was to develop a dress code policy for restricted and semi-restricted areas. The policy was to provide guidelines for surgical scrub attire and other items that are worn within and outside of the restricted areas. This policy was developed at The Canberra Hospital (TCH) in conjunction with key players from the operating rooms (OR), cardiac catheter laboratory, delivery suite, endoscopy and medical imaging. We believe the development of policies that give clear guidelines to staff on the use of theatre attire and dress standards within theatre are essential. Failure to adhere to these guidelines will leave those who visit and/or work in hospitals to have a 'perception' that infection control standards are less likely to be followed. 'Sloppy' dress code can be perceived as 'sloppy' work and infection control practices. While many issues to do with dress standards have not been subjected to rigorous independent scientific studies, the basis behind the dress standard follows many procedures introduced over 100 years ago to combat frequent infective complications of surgery. These practices are 'common sense' and have biological plausibility on how these 'customs' protect both staff and patients. We believe these practices should be followed unless well-controlled scientific studies show they are not needed. The development and implementation of such policies will make it much easier for infection control practitioners and other HCWs to 'police' those that disregard the code of dress standards.