1
|
Nordrum OL, Aylward P, Callaghan M. Hospital doctors’ attire during COVID-19 and beyond: time for a permanent change. Ir J Med Sci. [PMID: 35064535 PMCID: PMC8782673 DOI: 10.1007/s11845-022-02922-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 01/06/2022] [Indexed: 11/07/2022]
Abstract
Background The debate on current doctors’ attire in Irish hospital resurfaced alongside COVID-19, as a shift in doctors’ attire from professional attire to scrubs was observed. Aim The current study aimed to explore whether COVID-19 has changed the way in which hospital doctors perceive their personal attire, and whether this group wish for changes implemented during COVID-19 to become permanent. Methods Hospital doctors (n = 151), across all specialties and seniority at University Hospital Galway (UHG), filled out a ten-point online questionnaire exploring their experience of and attitudes towards hospital attire during COVID-19. Data collected and analysed in August–September 2020. Results Seventy-six percent (119) changed their attire during COVID-19 to scrubs (54% to hospital provided; 22% to private). Thirty-eight percent (56) reported feeling uncomfortable with bringing clothing home, highlighting the infection control risk. Seventy-four per cent (110) wanted the change to scrubs as standard attire to become permanent (65% to hospital provided; 9% to private). Thirty-two percent (47) noted a change in patients’ perception when wearing scrubs. Conclusion Hospital doctors changed their attire during COVID-19, and 75% would like these changes to become permanent. Most (67%) did not notice a change in their patient’s perception of them, raising questions about the longstanding beliefs surrounding ‘professional attire’. A large number of doctors are also worried about bringing clothing home. The humble hospital scrubs have shown their worth amidst the COVID-19 pandemic. Why not continue to wear them?
Collapse
|
2
|
Lena P, Ishak A, Karageorgos SA, Tsioutis C. Presence of Methicillin-Resistant Staphylococcus aureus (MRSA) on Healthcare Workers' Attire: A Systematic Review. Trop Med Infect Dis 2021; 6:42. [PMID: 33807299 PMCID: PMC8103237 DOI: 10.3390/tropicalmed6020042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 03/28/2021] [Accepted: 03/30/2021] [Indexed: 12/19/2022] Open
Abstract
Contaminated healthcare workers' (HCW) clothing risk transferring methicillin-resistant Staphylococcus aureus (MRSA) in healthcare facilities. We performed a systematic review in Pubmed and Scopus for 2000-2020 according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to analyze evidence of MRSA on HCW attire. The primary study outcome was MRSA isolation rates on HCW clothing in healthcare settings. Out of 4425 articles, 23 studies were included: 18 with 1760 HCWs, four with 9755 HCW-patient interactions and one with 512 samples. There was a notable variation in HCWs surveyed, HCW attires, sampling techniques, culture methods and laundering practices. HCW attire was frequently colonized with MRSA with the highest rates in long-sleeved white coats (up to 79%) and ties (up to 32%). Eight studies reported additional multidrug-resistant bacteria on the sampled attire. HCW attire, particularly long-sleeved white coats and ties, is frequently contaminated with MRSA. Banning certain types and giving preference to in-house laundering in combination with contact precautions can effectively decrease MRSA contamination and spread.
Collapse
Affiliation(s)
- Pavlina Lena
- School of Sciences, European University Cyprus, Nicosia 2404, Cyprus;
| | - Angela Ishak
- School of Medicine, European University Cyprus, Nicosia 2404, Cyprus; (A.I.); (S.A.K.)
| | - Spyridon A Karageorgos
- School of Medicine, European University Cyprus, Nicosia 2404, Cyprus; (A.I.); (S.A.K.)
- Department of Pediatrics, Limassol General Hospital, Limassol 3304, Cyprus
| | - Constantinos Tsioutis
- School of Medicine, European University Cyprus, Nicosia 2404, Cyprus; (A.I.); (S.A.K.)
| |
Collapse
|
3
|
Travers J, Leong CS, FitzGerald SF. White coats as reservoirs of pathogens: would student doctors prefer to discard them and how do they impact their confidence? J Hosp Infect 2018; 100:e151-e152. [PMID: 29936080 DOI: 10.1016/j.jhin.2018.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 06/14/2018] [Indexed: 10/28/2022]
Affiliation(s)
- J Travers
- Department of Emergency Medicine, Mater Misericordiae Hospital, Dublin, Ireland.
| | - C S Leong
- School of Medicine, University College Dublin, Dublin, Ireland
| | - S F FitzGerald
- School of Medicine, University College Dublin, Dublin, Ireland; Department of Clinical Microbiology, St Vincent's University Hospital, Dublin, Ireland
| |
Collapse
|
4
|
Lefor AK, Ohnuma T, Nunomiya S, Yokota S, Makino J, Sanui M. Physician attire in the intensive care unit in Japan influences visitors' perception of care. J Crit Care 2017; 43:288-293. [PMID: 28965038 DOI: 10.1016/j.jcrc.2017.09.181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 09/16/2017] [Accepted: 09/24/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE The objective of this study is to evaluate the impact of physician attire and behavior on perceptions of care by ICU visitors in Japan. MATERIALS AND METHODS Visitors were surveyed including 117 at a community hospital and 106 at a university hospital. Demographic data (age, gender, relationship to patient, length of stay) were collected. A seven-point Likert scale (1=strongly agree, 4=neutral, 7=strongly disagree) was used to judge physician attire (name tag, white coat, scrubs, short sleeve shirts, blue jeans, sneakers, clogs), behavior (addressing a patient, carrying a snack) and overall effect on perception of care. RESULTS There are no significant differences (p>0.05) in demographics comparing the two ICUs, except for increased length of stay at the university ICU. Visitors scored the importance of a name tag (median 2, Interquartile Range 1-2), white coat [3,1-4], addressing the patient by last name [2,1-3], wearing scrubs [3,2-4], sneakers [4,3-5], clogs [4,4-5], short sleeves (4,3.5-5), blue jeans [5,4-6], and carrying a snack [6,5-7]. Visitors scored "attire affects perceptions of care" as [3,2-4]. CONCLUSIONS Physician attire in the ICU affects perceptions of care. Implementation of attire guidelines which require clothing that does not meet visitor preferences should be accompanied by education programs.
Collapse
Affiliation(s)
| | - Tetsu Ohnuma
- Department of Anesthesiology and Critical Care Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Shin Nunomiya
- Division of Intensive Care, Department of Anesthesiology and Intensive Care Medicine, Jichi Medical University, Tochigi, Japan
| | | | - Jun Makino
- Department of Anesthesiology and Critical Care Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Masamitsu Sanui
- Department of Anesthesiology and Critical Care Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan
| |
Collapse
|
5
|
Riley K, Williams J, Owen L, Shen J, Davies A, Laird K. The effect of low-temperature laundering and detergents on the survival ofEscherichia coliandStaphylococcus aureuson textiles used in healthcare uniforms. J Appl Microbiol 2017; 123:280-286. [DOI: 10.1111/jam.13485] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 04/07/2017] [Accepted: 04/30/2017] [Indexed: 11/30/2022]
Affiliation(s)
- K. Riley
- The School of Pharmacy; De Montfort University; Leicester UK
- Textile Engineering and Materials Research Group; School of Design; De Montfort University; Leicester UK
| | - J. Williams
- Textile Engineering and Materials Research Group; School of Design; De Montfort University; Leicester UK
| | - L. Owen
- The School of Pharmacy; De Montfort University; Leicester UK
| | - J. Shen
- Textile Engineering and Materials Research Group; School of Design; De Montfort University; Leicester UK
| | - A. Davies
- Textile Engineering and Materials Research Group; School of Design; De Montfort University; Leicester UK
| | - K. Laird
- The School of Pharmacy; De Montfort University; Leicester UK
| |
Collapse
|
6
|
Haun N, Hooper-Lane C, Safdar N. Healthcare Personnel Attire and Devices as Fomites: A Systematic Review. Infect Control Hosp Epidemiol 2016; 37:1367-73. [PMID: 27609491 DOI: 10.1017/ice.2016.192] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Transmission of pathogens within the hospital environment remains a hazard for hospitalized patients. Healthcare personnel clothing and devices carried by them may harbor pathogens and contribute to the risk of pathogen transmission. OBJECTIVE To examine bacterial contamination of healthcare personnel attire and commonly used devices. METHODS Systematic review. RESULTS Of 1,175 studies screened, 72 individual studies assessed contamination of a variety of items, including white coats, neckties, stethoscopes, and mobile electronic devices, with varied pathogens including Staphylococcus aureus, including methicillin-resistant S. aureus, gram-negative rods, and enterococci. Contamination rates varied significantly across studies and by device but in general ranged from 0 to 32% for methicillin-resistant S. aureus and gram-negative rods. Enterococcus was a less common contaminant. Few studies explicitly evaluated for the presence of Clostridium difficile. Sampling and microbiologic techniques varied significantly across studies. Four studies evaluated for possible connection between healthcare personnel contaminants and clinical isolates with no unequivocally direct link identified. CONCLUSIONS Further studies to explore the relationship between healthcare personnel attire and devices and clinical infection are needed. Infect Control Hosp Epidemiol 2016;1-7.
Collapse
|
7
|
Palacios-González C, Lawrence DR. Substance over style: is there something wrong with abandoning the white coat? J Med Ethics 2015; 41:433-436. [PMID: 25048814 PMCID: PMC4453716 DOI: 10.1136/medethics-2013-101900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 06/13/2014] [Accepted: 07/02/2014] [Indexed: 06/03/2023]
Abstract
In this paper, we address points raised by Stephanie Dancer's article in The BMJ in which she claimed that by 'dressing down', physicians fail to adhere to the dignitas of the medical profession, and damage its reputation. At the beginning of this paper, we distinguish between two different senses in which a person can be, as she terms it, 'scruffy'; and then we address Dancer's three main claims. First, we argue that in regard to the medical profession it is fallacious to assume, as she appears to do, that someone is incompetent or irresponsible when such a judgement is grounded in the fact that a physician is not dressed in a formal way. Second, we argue, contrary to her claim, that the dignified nature of the medical profession is in no coherent way linked to sartorial elegance or lack thereof, but rather, that such dignity is bound to the value of the medical practice in itself, to patients, and to society at large. Third, we examine two ways in which doctors can 'dress down' and show that 'scruffiness' does not necessarily intimates a lack of personal hygiene. Finally, we show that pointing to mere statistical correlation without causation, cannot be used as an argument against scruffiness. We conclude by suggesting that in the medical context, it is more appropriate to educate patients than to chastise practitioners for not following arbitrary cultural mores.
Collapse
Affiliation(s)
| | - David R Lawrence
- Institute for Science Ethics and Innovation, The University of Manchester, Manchester, UK
| |
Collapse
|
8
|
Affiliation(s)
- R A Stein
- Department of Biochemistry and Molecular Pharmacology, New York University School of Medicine, New York, NY, USA. ,
| |
Collapse
|
9
|
|
10
|
Chang YJ, Yeh ML, Li YC, Hsu CY, Lin CC, Hsu MS, Chiu WT. Predicting hospital-acquired infections by scoring system with simple parameters. PLoS One 2011; 6:e23137. [PMID: 21887234 PMCID: PMC3160843 DOI: 10.1371/journal.pone.0023137] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2011] [Accepted: 07/07/2011] [Indexed: 11/18/2022] Open
Abstract
Background Hospital-acquired infections (HAI) are associated with increased attributable morbidity, mortality, prolonged hospitalization, and economic costs. A simple, reliable prediction model for HAI has great clinical relevance. The objective of this study is to develop a scoring system to predict HAI that was derived from Logistic Regression (LR) and validated by Artificial Neural Networks (ANN) simultaneously. Methodology/Principal Findings A total of 476 patients from all the 806 HAI inpatients were included for the study between 2004 and 2005. A sample of 1,376 non-HAI inpatients was randomly drawn from all the admitted patients in the same period of time as the control group. External validation of 2,500 patients was abstracted from another academic teaching center. Sixteen variables were extracted from the Electronic Health Records (EHR) and fed into ANN and LR models. With stepwise selection, the following seven variables were identified by LR models as statistically significant: Foley catheterization, central venous catheterization, arterial line, nasogastric tube, hemodialysis, stress ulcer prophylaxes and systemic glucocorticosteroids. Both ANN and LR models displayed excellent discrimination (area under the receiver operating characteristic curve [AUC]: 0.964 versus 0.969, p = 0.507) to identify infection in internal validation. During external validation, high AUC was obtained from both models (AUC: 0.850 versus 0.870, p = 0.447). The scoring system also performed extremely well in the internal (AUC: 0.965) and external (AUC: 0.871) validations. Conclusions We developed a scoring system to predict HAI with simple parameters validated with ANN and LR models. Armed with this scoring system, infectious disease specialists can more efficiently identify patients at high risk for HAI during hospitalization. Further, using parameters either by observation of medical devices used or data obtained from EHR also provided good prediction outcome that can be utilized in different clinical settings.
Collapse
Affiliation(s)
- Ying-Jui Chang
- Graduate Institute of Medical Science, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Dermatology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Min-Li Yeh
- Graduate Institute of Medical Science, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Oriental Institute of Technology, New Taipei, Taiwan
| | - Yu-Chuan Li
- Department of Dermatology, Taipei Medical University Wan Fang Hospital, Taipei, Taiwan
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- * E-mail: (YCL); (CYH)
| | - Chien-Yeh Hsu
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- Center of Excellence for Cancer Research (CECR), Taipei Medical University, Taipei, Taiwan
- * E-mail: (YCL); (CYH)
| | - Chao-Cheng Lin
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Meng-Shiuan Hsu
- Section of Infectious Disease, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Wen-Ta Chiu
- Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan
| |
Collapse
|
11
|
Webb DR, Lawrentschuk N. Evolution of the USANZ tie. BJU Int 2011; 107 Suppl 3:4-6. [PMID: 21492368 DOI: 10.1111/j.1464-410x.2011.10051.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
• The Urological Society of Australia and New Zealand (USANZ) tie represents the dual nationality of the society, the ancient history of urology, and the continuing development of urology in Australia and New Zealand. • The earliest badge of the Urological Society of Australasia (USA) was a cartoon depiction of the cystoscopic view of a prostate from the urethra. The inception of the USANZ tie began with the borrowing of the crest of the newly granted USA coat of arms (lynx holding an exploratorium) as the logo for the USA Annual Scientific Meeting Tie in 1988. This tie was adopted de facto as the USA Society Tie; it became the template for subsequent scientific meeting ties, from which the formal USANZ tie design was adapted in 2006, to coincide with and mark the new society name, from the USA to the USANZ. This paper traces the evolution of the USANZ tie.
Collapse
Affiliation(s)
- David R Webb
- University of Melbourne, Department of Surgery Austin Health, Studley Rd, Heidelberg, Melbourne, Victoria 3084, Australia.
| | | |
Collapse
|
12
|
|