Sacrificing the white coat for infection control?

Sacrificing the white coat for infection control?
Sacrificing the white coat for infection control?
Infection control is a necessary part of health care. In many hospitals, there are personnel to monitor nurses and other healthcare professionals to ensure they are performing adequate hand hygiene.

There are often committees and personnel designated to improving policies and procedures to ensure that disease is not spread in the hospital setting. Hospital operating rooms have been one of the main targets of infection control policies and monitoring. 

An article recently published by the Society for Healthcare Epidemiology of America in the Journal of Infection Control and Hospital Epidemiology hypothesizes that cleaner attire for personnel is needed

Common professional attire includes watches, rings, ties and long sleeves, all of which increase the potential for the transmission of bacteria.

This includes the traditionally worn white coat -- although important in distinguishing the healthcare provider as such, it may actually be working against the "Do no harm" mantra by which we abide. 

There are few studies examining the role of personal attire in the spread of infection. More are needed, especially in the outpatient setting. Although hand hygiene is expected, there are few rules regarding appropriate attire for infection control.

Specifically, regulation is needed regarding the frequency of laundering the white coat that is worn daily and consistently comes in contact with multiple patients in the outpatient setting. Currently available research suggests any article worn "at the bedside" that comes in contact with the patient or patient environment should be laundered daily, or at the very least, weekly. 

It is unlikely that primary care providers clean their coats daily and likely only a few engage in weekly laundering of their coats. Providers need to be more aware of the potential for the spread of disease via clothing, implement more frequent laundering or the removal of the coat prior to examining the patient.

Completely forbidding the use of the white coat does not seem reasonable considering its long history and associated patient beliefs and feelings. One potential solution is to equip exam rooms with hooks or coat racks, enabling the coat to be removed and properly stored to avoid direct contact with the patient.

All healthcare providers should be encouraged to pay more attention to their personal attire and more frequent laundering should occur. This is especially true if you can't remember your last trip to the dry cleaner.

Leigh Montejo, MSN, FNP-BC, provides health care to underserved populations at the Metropolitan Community Health Service's Agape Clinic in Washington, North Carolina.

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