Disciplinary action is taken at the discretion of each hospital, but Patrick said serious cases of hygiene noncompliance area rare.
In general, hospitals do their best to keep staff well trained and updated in hospital procedure regarding cleanliness and infection risk reduction, with refresher courses about once a year, said Patrick, who is also a member of the Association of Professionals in Infection Control and Epidemiology.
"At Baylor, each year we are updated," said Dr. Benoy Benny, assistant professor of physical medicine and rehabilitation at Baylor College of Medicine in Houston, Texas. "We don't want to bring infections in to [patients] if they are immunocompromised."
Virulent diseases and cancers, particularly ones such as leukemia in which the immune system is weak and the white blood cell count is low, are ones where a visitor should take more care than usual with their cleanliness.
The practice which sticks best for people is hand hygiene. Washing hands before and after seeing a patient and using gel hand sanitizers is standard practice in every hospital, Patrick said, and the best way to minimize infections.
A 2005 study at the University of North Carolina at Chapel Hill testing different methods of hand hygiene showed that a 10 second scrub with soap and water could remove about 90 percent of the bacteria on the hands. Alcohol-based hand gels removed about 50 percent of bacteria.
The key, it seems, is having the right products in the right places.
Dispensers of soap or gel hand sanitizers are usually located in each room and at strategic locations in hallways and on desks.
"If there's anything procedural, physicians will was their hands before and after," Benny said. "It's part of a normal routine."
Patrick said that the Tacoma hospitals could, in a busy month, go through over two gallons of soap and gel.
"Our motto is 'gel in, gel out'," Patrick said.
But the nature of a hospital is to harbor germs, and sometimes illnesses are impossible to avoid. Nor is it easy to keep work contaminants from spreading to other areas of a staffer's life.
"As soon as I step into [my] house, I always wash my hands again," Benny said. But with a 20-month-old son waiting at home, he admits it is sometimes hard to shower and change out of the clothing he wore at work first.
But changes such as the purple scrubs Kastenbaum instituted may be the direction in which the medical community wishes to go. He said the outfits have boosted the reputation and the professionalism of the hospital staff.
"We've got to get back to being strict," Kastenbaum said. "Some people are going to get an infection, we can't be perfect. But boy we've got to try."