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Do you know how long Staph aureus can live on your uniform?

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Unlike in many other European countries, responsibility for laundering uniforms in the UK has mainly been handed to nurses themselves. Gone are the days when at the end of your shift you could go to your locker, change out of your dirty uniform, put it into a laundry basket and then collect it crisp and neatly folded from the hospital laundry a few days later.

The majority of nurses are now expected to wash their own uniforms at home following Department of Health guidance, which specifies a 10-minute wash at 60°C in order to remove all micro-organisms.

According to the guidance, it is good practice to wear a clean uniform on every shift and for soiled uniforms to be stored and washed separately from other laundry items.

Our February cover article looks at how realistic these expectations are for a workforce that is under-resourced and over-stretched.

Two studies carried out at De Montfort University found that home laundering was often not carried out according to the guidance and so was not safe and effective.

“Researchers also found washing heavily soiled items with other items at 40°C resulted in some contamination of other items during the wash”

One study found that 44% of 265 healthcare staff washed their uniforms below the specified 60°C, and that a quarter of staff wore their uniform for more than one shift.

A follow-up study last year found that Staphylococcus aureus and Escherichia coli were able to survive on polyester fabric for up to seven days and for up to 21 days on cotton; this ability increases the risk of cross contamination in the home.

Researchers also found washing heavily soiled items with other items at 40°C resulted in some contamination of other items during the wash. This means there is a theoretical risk that other items in the same washload could be contaminated by your uniform.

There are many reasons why nurses are not able to comply with the guidance. The requirement to wash uniforms separately and at 60°C puts a strain on even the best domestic machine over time.

“Hospitals need to provide proper changing and locker facilities so that staff can change when they get to work and at the end of the shift”

Many nurses are not provided with enough uniforms to wear a clean one every day and who puts on their washing machine – and tumble drier if it is needed quickly – for one uniform? Indeed, who can afford to?

Although some hospitals do provide laundry facilities, it is often not realistic for nurses to visit them after a shift – this too would be eased by nurses having a bigger stock of uniforms so making using the hospital laundry more practical.

Our expert authors call for a return to the days of in-house industrial laundering of uniforms to ensure they are correctly washed and reduce the risk of cross contamination.

However, to make this work, hospitals need to provide proper changing and locker facilities so that staff can change when they get to work and at the end of the shift.

This is a thorny issue and one that staff have strong views on. To that end we have provided journal club materials with our cover articles to help you lead a discussion with your team on this important issue.

 

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