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Abstract
Aim To ascertain the provision and decontamination of uniforms within a cross-section of NHS trusts in the UK and to compare policies regarding their use.
Method A questionnaire was circulated to 170 NHS trust infection control teams in the UK. Eighty-six (51 per cent) responses were received, which represented 101 NHS trusts.
Results Less than half of the trusts (47 per cent) provide adequate numbers of uniforms to allow a clean uniform per shift. Only 26 per cent had adequate on-site staff changing facilities and 65 per cent did not launder uniforms. The majority of nursing staff (91 per cent) were compelled, by a combination of these factors, to launder their uniforms at home. Few were provided with any guidance on how to do this safely.
Conclusion There is an urgent need for minimum standards to be set for the provision of uniforms, laundering and changing facilities, to minimise the potential for spread of healthcare-associated infections.
Keywords
Cross-infection; Infection control; Laundry services; Nursing profession; Uniforms
These keywords are based on the subject headings from the British Nursing Index. This article has been subject to double-blind review. For related articles and author guidelines visit the online archive at www.nursing-standard.co.uk and search using the keywords.
Healthcare staff uniforms are frequently contaminated by disease-causing bacteria, including Staphylococcus aureus, Clostridium difficile and glycopeptide-resistant enterococci (GRE), presenting a potential source of crossinfection in the clinical setting (Babb etal 1983, Perry et al 2001, Speers et al 1969). Maximum contamination occurs in areas of greatest hand contact, that is, pockets, cuffs and aprons (Babb et al 1983, Loh et al 2000, Wongeia/1991), allowing re-contamination of washed hands.
While hand hygiene is well recognised as the single most important factor in the prevention of cross-infection, contact transfer of bacteria from uniforms leading to infection has also been described (Hambraeus 1973, Hambraeus and Ransjol977).
In a study which demonstrated that contamination of uniforms might be a significant contributory factor to the spread of nosocomial infection, Callaghan (1998a) highlighted the widespread problem of inadequate provision of uniforms and laundering facilities in hospitals. This resulted in many staff travelling to and from work in uniforms which they laundered themselves in a domestic washing machine. Callaghan (1998b) found it impossible to persuade the hospital...