scrubs are not for strutting

you’ve all seen them: at the gym, at a restaurant, at a coffee shop on sunday morning . . . really, scrubs are not a fashion statement. wear them where they are meant:

New York Times


September 23, 2008

The Doctor’s Hands Are Germ-Free. The Scrubs Too?

Many hospitals have stepped up efforts to encourage regular hand washing by doctors. But what about their clothes?

Amid growing concerns about hospital infections and a rise in drug-resistant bacteria, the attire of doctors, nurses and other health care workers — worn both inside and outside the hospital — is getting more attention. While infection control experts have published extensive research on the benefits of hand washing and equipment sterilization in hospitals, little is known about the role that ties, white coats, long sleeves and soiled scrubs play in the spread of bacteria.

The discussion was reignited this year when the British National Health Service imposed a “bare below the elbows” rule barring doctors from wearing ties and long sleeves, both of which are known to accumulate germs as doctors move from patient to patient.

(In the United States, hospitals generally require doctors to wear “professional” dress but have no specific edicts about ties and long sleeves.)

But while some data suggest that doctors’ garments are crawling with germs, there’s no evidence that clothing plays a role in the spread of hospital infections. And some researchers report that patients have less confidence in a doctor whose attire is casual. This month, the medical journal BJU International cited the lack of data in questioning the validity of the new British dress code.

Still, experts say the absence of evidence doesn’t mean there is no risk — it just means there is no good research. A handful of reports do suggest that the clothing of health workers can be a reservoir for risky germs.

In 2004, a study from the New York Hospital Medical Center of Queens compared the ties of 40 doctors and medical students with those of 10 security guards. It found that about half the ties worn by medical personnel were a reservoir for germs, compared with just 1 in 10 of the ties taken from the security guards. The doctors’ ties harbored several pathogens, including those that can lead to staph infections or pneumonia.

Another study at a Connecticut hospital sought to gauge the role that clothing plays in the spread of methicillin-resistant Staphylococcus aureus, or MRSA. The study found that if a worker entered a room where the patient had MRSA, the bacteria would end up on the worker’s clothes about 70 percent of the time, even if the person never actually touched the patient.

“We know it can live for long periods of time on fabrics,” said Marcia Patrick, an infection control expert in Tacoma, Wash., and co-author of the Association of Professionals in Infection Control and Epidemiology guidelines for eliminating MRSA in hospitals.

Hospital rules typically encourage workers to change out of soiled scrubs before leaving, but infection control experts say enforcement can be lax. Doctors and nurses can often be seen wearing scrubs on subways and in grocery stores.

Ms. Patrick, who is director of infection prevention and control for the MultiCareHealth System in Tacoma, says it’s unlikely that brief contact with a scrub-wearing health care worker on the subway would lead to infection. “The likelihood is that the risk is low, but it’s also probably not zero,” she said.

While the role of clothing in the spread of infection hasn’t been well studied, some hospitals in Denmark and Europe have adopted wide-ranging infection-control practices that include provisions for the clothing that health care workers wear both in and out of the hospital. Workers of both sexes must change into hospital-provided scrubs when they arrive at work and even wear sanitized plastic shoes, also provided by the hospital. At the end of the day, they change back into their street clothes to go home.

The focus on hand washing, sterilization, screening and clothing control appears to have worked: in Denmark, fewer than 1 percent of staph infections involve resistant strains of the bacteria, while in the United States, the numbers have surged to 50 percent in some hospitals.

But American hospitals operate on tight budgets and can’t afford to provide clothes and shoes to every worker. In addition, many hospitals don’t have the extra space for laundry facilities.

Ann Marie Pettis, director of infection prevention for the University of Rochester Medical Center, says most hospitals are focusing on hand washing and equipment sterilization, which are proven methods known to reduce the spread of infection. But she adds that her hospital, like many others, has a policy against wearing scrub attire to and from work, even though there is no real evidence that dirty scrubs pose a risk to people in the community.

“Common sense tells us that the things we are wearing as health care providers should be freshly laundered,” Ms. Pettis said. After all, she went on, the wearing of scrubs in public “raises fear” among consumers.

“I don’t think we should feed into that,” she said. “Scrubs shouldn’t be worn out and about.”

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vote. vote. vote.

don’t forget: REGISTER TO VOTE. registration closes out in a few weeks:

http://www.rockthevote.org/

snl: palin versus clinton

fabulous.

period control.

hilarious. merci beaucoup sf.

http://current.com/items/89157733_target_women_birth_control

also, usefulness of comprehensive sexual education (http://www.guttmacher.org).

tell your legislators to support comprehensive sexual education and reproductive health care services next Wednesday, September 17th, during our national call in regarding the Prevention First Act. Find out more information at www.amsa.org/gender/getoutthevote.cfm.

digital intimacy (nyt)

social networks. super interesting.

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http://www.nytimes.com/2008/09/07/magazine/07awareness-t.html?ex=1378440000&en=b87f67f56fa2fbe2&ei=5124&partner=permalink&exprod=permalink

Brave New World of Digital Intimacy

Published: September 5, 2008

Peter Cho

ghost bike installation in memory of blanca

19 year old pharmacy student Blanca Ocasio was killed riding her bike near her Logan Square home on September 11 2007.

Please join family, friends, and neighbors of Blanca on Thursday, September 11, 2008 for a rally, candlelight procession, and ghost bike installation ceremony. We will gather at 7 PM at the west end of Palmer Square, 2200 N. Kedzie Blvd.; at 7:30 we will hear from family, friends, and representatives of Logan Square Walks and the Chicagoland Bicycle Federation, and then proceed with a candlelight procession to the intersection of Armitage and Kedzie where a ghost bike for Blanca will be installed.

Please come out and show your support for Blanca’s family and friends, and for safer streets for our most vulnerable users.

Info here:
http://www.thechainlink.org/events/event/show?id=2211490:Event:5775

http://breakthegridlock.org/node/124074

Press release here:
http://breakthegridlock.org/files/breakthegridlock/BlancaPR.pdf

DHHS regulations: open-letter (sent around)

In the midst of the media’s obsession with Bristol Palin’s “out-of-wedlock” hump and her mother’s decision to carry her Down Syndrome child, this is an open-ended letter concerning the new proposed regulations issued by the Department of Health and Human Services last Thursday, August 21st 2008.

These regulations, if passed, will greatly reduce the COMPREHENSIVE quality of reproductive health care that patients receive.  Under the guise of protecting a physician’s right to refuse to perform certain tasks based on moral or religious views, the HHS regulations are nothing more than an attempt to further erode patients’ ability to access complete and medically accurate health care. Conscience clauses have been in existence for decades, but under the proposed HHS regulations, a physician can refuse to not only perform certain medical procedure, but refuse to counsel or refer the patient to another physician. The regulations completely ignore the role of the physician as public servant, or as a health care provider responsible to their patients: the people that trust them to provide accurate and complete medical aid.  With these regulations doctors will no longer be required to provide sound medical care.

Current regulations forbid any institution receiving federal funding from discriminating against an employee based on diverging moral or religious views. If a physician has a moral objection to performing an abortion, s/he would not have to perform it but was expected to refer the patient to a physician willing to perform the procedure. These new proposed regulations go further, allowing the physician to refuse to perform options counseling or offer a referral. With access to good health care already a crisis in the United States, the HHS’ proposition places more barriers between patients and the quality health care they deserve. With the institutionalizing of these regulations a doctor’s personal moral or religious bias is given more credence than a patient’s need for good health care.  HHS funding for public health centers is created by the public, through taxes, and should be put toward programs that help the public, rather than being spent on programs that set the United States further behind the industrial world in terms of health care.

These regulations will impact the education that medical students will receive.  Under these regulations any healthcare professional will be able to refuse to “deal with” subjects that offend their sensibilities.  This means that not only could a doctor refuse to refer a patient to another physician who would be willing to provide the necessary care, but professors at publically funded medical schools can refuse to teach how to provide that care.  If these institutions ask a doctor, hired for the teaching of this care, to cover the subject, they would be at risk of losing their federal funds.  The implications here are that even future doctors who wish to learn how to provide comprehensive reproductive healthcare, may find it impossible to do so.  The United States is already facing a shortage of abortion providers and the HHS regulations if accepted will speed up the extinction of this necessary medical specialist.

Politics have no room in the examination room! The doctor is a specialist meant to provide healthcare, not restrict it.  And, as issues surrounding contraception and healthcare are frequently framed as moral dilemmas, I feel the need to ask what is more moral; to provide good comprehensive medical care, or to refuse?

In Peace and Health,
Yalda Afshar
MD/PhD candidate, Medical Scientist Training Program
University of Illinois at Chicago

update from st. paul (passing it on . . . )

Dear Friends –

Greetings from St. Paul.  I’m going to forward several articles from anti-war and corporate media sources that you might not have seen.  I also wanted to tell you that the action here is not over:  there will be one more march tomorrow when McCain appears.  Stay tuned.

In struggle –
JI

http://www.startribune.com/politics/national/conventions/27782184.html?elr=KArksLckD8EQDUoaEyqyP4O:DW3ckUiD3aPc:_Yyc:aUnciatkEP7DhUsX

http://www.743teamsters.org/

http://webmail.earthlink.net/wam/msg.jsp?msgid=125992&folder=INBOX&isSeen=true&x=-1359661246

http://socialistworker.org/2008/09/02/marching-on-the-rnc

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To see a list of speakers from Monday’s rally of 30,000 in St. Paul:

http://www.marchonrnc.org/node/70

Chicago speakers included:

Richard Berg, Teamsters 743
Jorge Mujica, March 10th Committee
Hatem Abudeyyeh, Palestine Solidarity Group
Kathy Kelly, Voices for Creative Non-Violence
Guillermo Rafael Cohen, Colombia Action Network
Joe Iosbaker . . .

To watch the speakers on CSPAN: http://www.cspan.org/search.aspx?For=rnc
(scroll down the page until you find “Marching Against the War” at RNC Rally)