If you’re a regular reader of my blog, you undoubtedly know the answer. Wearing jackets over scrub suits doesn’t prevent infections and adds costs.
Investigators from the University of Minnesota looked at infection rates one year before the institution of a mandatory warm-up jacket over scrub suit policy and one year after.
The rate of surgical site infection for the 13,302 cases done in the year before jackets had to be worn was 2.42% compared to 2.67% for the 12,998 cases done during the year after. The difference was not statistically significant with a p value of 0.1998.
The cost of laundering the jackets was about $1000 per month and does not include their purchase and the time wasted by the staff in complying with the policy.
The warm-up jacket policy was mandated after a Centers for Medicaid and Medicare Services review of the hospital and was based on a recommendation by the Association of Perioperative Registered Nurses (AORN).
Research on this topic is sparse. In the mid-1980s, a group published remarkably similar papers in two nursing journals stating that colony counts from the shoulders of subjects wearing scrub suits were lower when cover gowns were used. The abstracts [available here and here] do not contain any data or statistics for comparison.
Another study from 2003 found no significant differences in colony counts of personnel whether they were wearing cover garments or not. However, only 75 subjects were involved.
The AORN has apparently seen the light because as of November 2014, its policy now reads as follows:
The collective evidence does not support wearing cover apparel to protect scrub attire from contamination, and there is evidence that lab coats worn as cover apparel can be contaminated with large numbers of pathogenic microorganisms.
Here’s the real question. Is there any relationship to bacterial colony counts on clothing and surgical site infection?