Preventing the spread of bacteria, viruses, and fungi is a top priority within the healthcare industry, since the transmission of such microbes leads to healthcare associated infections (HCAI). The risk and rate of such infections can be minimized, if not completely eliminated, through adherence to infection control policies. These policies are essential in order to protect patients, staff members, and the community-at-large.
One consideration for any adequate infection control policy is when and if to utilize disposable vs. laundered personal protective equipment (PPE), including scrubs and gowns. While economic and environmental costs should be considered, organizations must also assess which method has a greater overall effectiveness at preventing the spread of infection—the ultimate aim of PPE.
Understanding the Impact of Nosocomial Infections
Nosocomial infections or HCAI affect approximately 7 out of every 100 hospitalized patients in developed countries. To meet the criteria of a HCAI, the infection must occur within 48 hours after admission to a healthcare facility, 3 days following discharge, or 30 days following an operation.
Types of HCAI
Common types of HCAI include catheter-associated urinary tract infections, central line-associated bloodstream infections, surgical site infections, healthcare acquired pneumonia, and ventilator-associated pneumonia. About 90% of these infections are caused by bacteria, including Staphylococcus aureus, Enterococci, Escherichia coli, and Pseudonomas aeruginosa.
Who's at Risk?
While anyone admitted to a hospital or healthcare facility is at risk for developing a HCAI, certain people have a greater likelihood. This includes anyone admitted to an ICU, people with compromised immune systems, people who have been in a coma, people who have experienced trauma or shock, people over the age of 70, and people with a history of prolonged antibiotic use.
Consequences of Nosocomial Infections
The socioeconomic, prognostic, and public health impacts of such infections cannot be understated. HCAI are associated with prolonged hospitalization stays (up to 2.5 times longer), increased medical costs, and an increased rate of complications and mortality. Nosocomial infections may also be contributing to the rise of multi-drug resistant infections.
What the Evidence Says: Reasons to Choose Disposable Scrubs over Washable Scrubs
Studies generally indicate that disposable scrubs are at least an equal (and in some cases more effective) option for infection control compared to reusable apparel. Commonly cited reasons include reliability, effectiveness, cost, and comfort.
Material within reusable scrubs can wear down over time due to repeated use and laundering. Conversely, single-use, disposable gowns and scrubs are made with durable material and are not subject to the potentially detracting effects of things like reuse, transport, storage, laundering, and decontamination. Disposable gowns supplied by a facility are also less subject to incidental factors such as getting lost or damaged.
Many facilities opt to allow staff members to launder their scrubs at home. But this cost-effective measure inherently lacks regulation of antimicrobial measures (such as temperature and washing solutions) which could otherwise reduce the presence of pathogens.
As an example, a 2012 study published in the American Journal of Infection Control found that home-laundered scrubs had significantly more bacteria on them compared to hospital-laundered scrubs and disposable scrubs. This suggests that disposable apparel would be the preferable option in cases where laundering either in-hospital or through a vendor is not a feasible option.
Quality disposable apparel can also stand up to the many substances to which healthcare workers and their patients are routinely exposed, making the effective for Standard and Transmission-Based Precautions.
At least two studies have found that disposable surgical scrubs are actually less expensive compared to reusable options. While a strong economic case can't be made in either direction based on the current available data, it at least appears that the price of disposable apparel is competitive compared to reusable options. Individual healthcare facilities may opt to execute cost analyses to get a clearer idea of exactly how such a purchasing decision would impact the organization financially.
Advances in textiles and materials have helped disposable scrubs become much more comfortable than previous iterations. Research has indicated that breathability and temperature levels are in many cases comparable to reusable options.
Of course, personal preference is a factor to be considered. It's possible that hospital staff members would be more amenable switching to disposables if they were made aware of newer standards of comfort now available on the market.
The Bottom Line for Healthcare Facilities
Admission to a healthcare facility exposes a person to the risk of infection during their time there or soon after their discharge. Such nosocomial infections can have a dramatic impact on the immediate and long-term prognosis of patients, and can also threaten the health and safety of healthcare workers and the greater community.
To minimize the prevalence of nosocomial infections, facilities need to engage in consistent infection control policies. These policies need to include personal protective equipment that can reduce contamination and maintain reliable barriers between pathogens and people.
Realistically, washable scrubs and gowns may have a smaller environmental and economic impact than disposable apparel. But with due respect to healthcare facilities' bottom lines, the overall effectiveness of disposable scrubs in preventing the transmission of pathogens needs to be kept in mind. It's possible that reducing the incidence of HCAI through disposable scrubs can cut down on medical costs in the long run. The implication here is essential—that is, initial upfront costs associated with disposable scrubs can be reasonably be expected to be offset by their effectiveness at keeping people safe and preventing illness.
Disposable, single-use scrubs may be the more desirable option for healthcare staff members as a way to protect themselves, their patients, and even their own families and community. Disposable scrubs available on the market today are more comfortable and breathable than ever and are made with durable material than can stand up to the common challenges of working in a healthcare environment. Ready to learn more about disposable scrubs? Learn more about our Soft Scrubs™ from International Enviroguard.