At the end of a work shift , C . difficile and MRSA can be recovered from the surfaces of nurses ’ uniforms at counts exceeding 500 colonyforming units ( CFU )… [ it has been ] reported that up to 60 percent of hospital staff uniforms were culture positive for
MDROs , based on samples taken from the sleeves , waists and pockets of the work apparel of more than 100 physicians and nurses .
• choices in detergent and laundry additives ( sours ). The current stance is hospital-directed laundering of employee scrubs and uniforms , although home laundering continues to be debated . The Occupational Safety and Health Administration ( OSHA ) regulations require employers to provide laundry processes for reusable personal protective equipment textiles and healthcare attire or uniforms with visible blood or other potentially infectious material contamination .”
Healthcare Personnel Attire and Opportunistic Pathogen Transmission
Healthcare worker movement around the hospital and the potential for the transmission of pathogenic organisms harbored on uniforms , scrubs , white coats and other garments is likely to “ represent a better source of substrates for bacterial growth ,” according to Mitchell , et al . ( 2015 ), who add , “ Microbes tend to thrive in moisture and protein-rich soil or dirt that may be found on apparel . Thus , apparel can readily acquire , retain and transmit epidemiologically significant pathogens such as MRSA . Typically , healthcare workers will wear the same clothing for one day or more , during which time their apparel will have direct or indirect contact with coworkers , patients and the general public . At the end of a work shift , C . difficile and MRSA can be recovered from the surfaces of nurses ’ uniforms at counts exceeding 500 colony-forming units ( CFU )… [ it has been ] reported that up to 60 percent of hospital staff uniforms were culture positive for MDROs , based on samples taken from the sleeves , waists and pockets of the work apparel of more than 100 physicians and nurses . Healthcare-associated pathogens were isolated from at least one site on 63 percent of the uniforms .”
TRSA / Hygienically Clean Healthcare surveys indicate public concern about allowing employees to wear healthcare garments to and from work ( and washing them at home ) and that infection preventionists believe this practice is an infection risk . A 2015 TRSA study of 700 adults regarding consumer perceptions of linens and uniforms asked respondents if they were concerned about medical professionals bringing germs into the outside world or back to healthcare facilities by wearing healthcare garments outside such facilities . More than two-thirds said they were somewhat or very concerned . The same survey found that more than 8 in 10 respondents believe that professional cleaning will result in cleaner lab coats than a policy that assigns workers to wash their own . Respondents to a 2017 survey of 1,400 infection preventionists at healthcare facilities were almost unanimous ( nearly 9 of 10 ) in their belief that wearing healthcare garments home presents an infection or contamination to those outside ; they were nearly as unified ( 8 in 10 ) in their contention that wearing scrubs into a hospital from home presents an infection or contamination risk to patients .
These same respondents indicated , however , that 54 percent of their facilities allowed employees to leave work while wearing their scrubs and clean them at home ; and 60 percent of facilities allowed employees to wear their scrubs into the hospital before work .
Healthcare facility managers were also questioned in 2015 as part of a business-to-business survey . Nearly half of respondents from such facilities said employees are responsible for laundering their own garments . Only 14 percent of respondents from facilities where individuals have such responsibility said training sessions are held to instruct staff in washing . Nearly half said no training at all is provided . But these respondents recognize the value of professional laundering . Nearly 90 percent of those with an opinion said outsourcing laundry and renting reusable textiles is a plus for reducing liability and that rental is more hygienic .
Inside the healthcare institution , great variability exists among laundering policies and attitudes toward transmissibility of pathogens via textiles .
As Mitchell , et al . ( 2015 ) confirm , “ Healthcare workers may have options to launder their work clothing , or some institutions may offer onsite industrial laundering for scrubs , lab coats and other apparel . Generally , industrial laundry procedures are sufficient to return garments and textiles free of microbial contamination . However , as Fijan , et al . discovered , no procedure is foolproof , and even if the laundering process itself produces nearly sterile garments , post-laundering practices ( sorting , folding and stacking ) can re-contaminate clean laundry
unless housekeeping personnel maintain a high level of vigilance . Fijan , et al . concluded that insufficient antimicrobial laundry procedures can result in spreading micro-organisms throughout even the clean areas of laundry facilities . They found that : 1 ) workers can re-contaminate clean laundry unless they receive regular training and education on proper hygiene and work area cleaning and disinfecting procedures ; and 2 ) regular cleaning and disinfecting of all laundry areas , especially the clean laundry area , is necessary to prevent the recontamination of laundered textiles during the post-laundry handling processes such as sorting , ironing , folding and packing . Fijan et al . specifically investigated the potential for hospital textiles to transmit rotaviruses and noted that rotavirus RNA could be detected in hospital laundry rinse water after the washing process , even after using accepted laundering procedures , and on laundered textiles , environmental surfaces in the laundry area and the hands of laundry workers .”
Vera , et al . ( 2016 ) provide some food for thought around recommendations for laundering of scrub uniforms and acknowledge that there is no nationally sanctioned scrub laundering method adopted as the standard : “ Practices for decontaminating scrubs have been largely left to institutional policy . Healthcare facilities often rely on organizational experts in infection control , such as the CDC , OSHA and AORN , during policy development . The CDC offers no recommendation on how or where to launder