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Comparing colony-forming units in inpatient nurses: Should military nurses who provide patient care wear hospital-provided scrubs?

Published online by Cambridge University Press:  29 August 2018

Gordon F. West ,
Marisol Resendiz ,
Michael B. Lustik  and
Md A. Nahid
Gordon F. West*
Affiliation:
Tripler Army Medical Center, Honolulu, Hawaii
Marisol Resendiz
Affiliation:
Tripler Army Medical Center, Honolulu, Hawaii
Michael B. Lustik
Affiliation:
Tripler Army Medical Center, Honolulu, Hawaii
Md A. Nahid
Affiliation:
Tripler Army Medical Center, Honolulu, Hawaii
*
Author for correspondence: Gordon West, 1 Jarrett White Road, Honolulu, HI 96859. E-mail:[email protected]
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Abstract

Objective

To compare bacterial contamination of military-approved uniforms and hospital-provided scrubs donned by nursing staff in an inpatient setting.

Design

Randomized experimental crossover study.

Setting

Large academic military medical center.

Methods

Inpatient units were randomized to predetermine the order of uniform sampling. Participants included nursing staff who provided direct patient care across 7 eligible inpatient units. Sampling of 6 designated sites on the uniform was completed on arrival to work, at ~4 hours into their shift, and at the 8-hour time point, for a total of 18 samples. Sampling of each participant occurred on 2 separate occasions, once in a military-approved uniform, and once in hospital-provided scrubs. After 24 hours of incubation, a colony-counting machine was used to calculate the total colony-forming units (CFU) of the sample.

Results

Across all time points, military-approved uniforms demonstrated a 2-fold bacterial increase at the abdominal site and 3-fold increases at the sleeve cuff and waist pocket regions compared to the same regions on hospital-provided scrubs.

Conclusion

Nurses should be aware that bacteria are present at much higher levels on their personal military uniforms compared to hospital-provided scrubs. Additional research is needed to determine whether these findings are a function of wear, laundering, or environmental factors. Nurses should adhere to daily uniform washing to reduce bacterial load and minimize risk of nosocomial infections to the patients they care for.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 39 , Issue 11 , November 2018 , pp. 1316 - 1321
Copyright
© 2018 by The Society for Healthcare Epidemiology of America. All rights reserved. 

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References

1. Marler, J. Antibiotic-resistant infection (MRSA) cost the US healthcare system excess of $20 billion annually. http://www.mrsablog.com/2009/10/articles/mrsa-outbreaks/antibioticresistant-infections-mrsa-cost-the-us-healthcare-system-in-excess-of-20-billion-annually/. Updated 2009. Accessed August 10, 2018.Google Scholar
2. Agency for Healthcare Research and Quality. Saving lives and saving money: hospital-acquired conditions update. http://www.ahrq.gov/professionals/quality-patient-safety/pfp/interimhacrate2014.html. Updated 2015. Accessed August 10, 2018.Google Scholar
3. Willis-Owen, CA, Subramanian, P, Kumari, P, Houlihan-Burne, D. Effects of ‘bare below the elbows’ policy on hand contamination of 92 hospital doctors in a district general hospital. J Hosp Infect 2010; 75:116–119.Google Scholar
4. Munoz-Price, LS, Arheart, KL, Lubarsky, DA, Birnbach, DJ. Differential laundering practices of white coats and scrubs among health care professionals. Am J Infect Control 2013;41:565–567.Google Scholar
5. Treakle, AM, Thom, KA, Furuno, JP, Strauss, SM, Harris, AD, Perencevich, EN. Bacterial contamination of health care workers’ white coats. Am J Infect Control 2009;37:101–105.Google Scholar
6. Wiener-Well, Y, Galuty, M, Rudensky, B, Schlesinger, Y, Attias, D, Yinnon, AM. Nursing and physician attire as possible source of nosocomial infections. Am J Infect Control 2011;39:555–559.Google Scholar
7. Boyce, J, Chenevert, C. Isolation gowns prevent health care workers (HCWs) from contaminating their clothing, and possibly their hands, with methicillin-resistant Staphylococcus aureus (MRSA) and resistant enterococci. Infect Control Hosp Epidemiol 1998;19:707.Google Scholar
8. Banu, A, Anand, M, Nagi, N. White coats as a vehicle for bacterial dissemination. J Clin Diagn Res 2012;6:1381–1384.Google Scholar
9. Wiener-Well, Y, Galuty, M, Rudensky, B, Schlesinger, Y, Attias, D, Yinnon, AM. Nursing and physician attire as possible source of nosocomial infections. Am J Infect Control 2011;39:555–559.Google Scholar
10. Griffin, KJ, Scott, DJ, Foster, N. Bare below the elbows. Ann R Coll Surg Engl 2011;93:181.Google Scholar
11. Burger, A, Wijewardena, C, Clayson, S, Greatorex, RA. Bare below elbows: Does this policy affect handwashing efficacy and reduce bacterial colonisation? Ann R Coll Surg Engl 2011; 93:13–16.Google Scholar
12. Loh, W, Ng, VV, Holton, J. Bacterial flora on the white coats of medical students. J Hosp Infect 2000;45:65–68.Google Scholar
13. Kuehn, BM. Time to hang up the white coat? Epidemiologists suggest ways to prevent clothing from spreading infection. JAMA 2014;311:786–787.Google Scholar
14. Krueger, CA, Murray, CK, Mende, K, Guymon, CH, Gerlinger, TL. The bacterial contamination of surgical scrubs. Am J Orthop (Belle Mead NJ) 2012;41:E69–E73.Google Scholar
15. Weber, RL, Khan, PD, Fader, RC, Weber, RA. Prospective study on the effect of shirt sleeves and ties on the transmission of bacteria to patients. J Hosp Infect 2012;80:252–254.Google Scholar
16. Mitchell, A, Spencer, M, Edmiston, C Jr. Role of healthcare apparel and other healthcare textiles in the transmission of pathogens: a review of the literature. J Hosp Infect 2015;90:285–292.Google Scholar
17. Sanon, MA, Watkins, S. Nurses’ uniforms: How many bacteria do they carry after one shift? J Public Health Epidemiol 2012;4:311–315.Google Scholar
18. Takashima, M, Shirai, F, Sageshima, M, Ikeda, N, Okamoto, Y, Dohi, Y. Distinctive bacteria-binding property of cloth materials. Am J Infect Control 2004;32:27–30.Google Scholar
19. Burden, M, Cervantes, L, Weed, D, Keniston, A, Price, CS, Albert, RK. Newly cleaned physician uniforms and infrequently washed white coats have similar rates of bacterial contamination after an 8‐hour workday: a randomized controlled trial. Journal of Hospital Medicine 2011;6:177–182.Google Scholar
20. Munoz-Price, LS, Arheart, KL, Mills, JP, et al. Associations between bacterial contamination of health care workers’ hands and contamination of white coats and scrubs. Am J Infect Control 2012;40:e245–e248.Google Scholar
21. Morgan, DJ, Rogawski, E, Thom, KA, et al. Transfer of multidrug-resistant bacteria to healthcare workers’ gloves and gowns after patient contact increases with environmental contamination. Crit Care Med 2012;40:1045–1051.Google Scholar
22. Peretz, A, Koiefman, A, Dinisman, E, Brodsky, D, Labay, K. Do wheelchairs spread pathogenic bacteria within hospital walls? World J Microbiol Biotechnol 2014;30:385–387.Google Scholar
23. Kramer, A, Schwebke, I, Kampf, G. How long do nosocomial pathogens persist on inanimate surfaces? A systematic review. BMC Infect Dis 2006;6:130–2334-6-130.Google Scholar
24. Gardner, P, Muller, MP, Prior, B, et al. Wheelchair cleaning and disinfection in Canadian health care facilities: “That’s wheelie gross!” Am J Infect Control 2014;42:1173–1177.Google Scholar
25. Bearman, G, Bryant, K, Leekha, S, et al. Healthcare personnel attire in non–operating-room settings. Infect Control Hosp Epidemiol 2014;35:107–121.Google Scholar
26. Burden, M, Cervantes, L, Weed, D, Keniston, A, Price, CS, Albert, RK. Newly cleaned physician uniforms and infrequently washed white coats have similar rates of bacterial contamination after an 8-hour workday: a randomized controlled trial. J Hosp Med 2011;6:177–182.Google Scholar
27. Callaghan, I. Implementing change: influencing the process. Nurs Stand 1998;13:41–44.Google Scholar
28. Fijan, S, Å ostar Turk, S. Hospital textiles, are they a possible vehicle for healthcare-associated infections? Int J Environ Res Public Health 2012;9:3330–3343.Google Scholar
29. Lakdawala, N, Pham, J, Shah, M, Holton, J. Effectiveness of low-temperature domestic laundry on the decontamination of healthcare workers’ uniforms. Infect Control Hosp Epidemiol 2011;32:1103–1108.Google Scholar
30. Patel, SN, Murray-Leonard, J, Wilson, APR. Laundering of hospital staff uniforms at home. J Hosp Infect 2006; 62:89–93.Google Scholar
31. Riley, K, Williams, J, Owen, L, Shen, J, Davies, A, Laird, K. The effect of low-temperature laundering and detergents on the survival of Escherichia coli and Staphylococcus aureus on textiles used in healthcare uniforms. J Appl Microbiol 2017.Google Scholar
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