Bacterial Contamination of Military and Civilian Uniforms in an Emergency Department

• Published in: Journal of emergency nursing Vol. 45; no. 2; pp. 169 - 177.e1
• Main Authors: West, Gordon F., Resendiz, Marisol, Lustik, Michael B., Nahid, Md A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-03-2019; Elsevier Limited
• Subjects: Abdomen; Adult; Bacterial contamination; Bacterial infection; Blood; Civilians; Colonies & territories; Contamination; Cotton; Cross Infection - microbiology; Cross-Over Studies; Disinfection; Emergency department; Emergency medical care; Emergency Service, Hospital; Emergency services; Equipment Contamination - statistics & numerical data; Female; Hospital uniform; Hospitals, Military; Humans; Hygiene; Infection Control; Infection prevention; Male; Medical personnel; Microorganisms; Middle Aged; Military hospitals; Military nursing; Military Personnel; Mortality; Multidrug resistant organisms; Nosocomial infections; Nurses; Nursing; Nursing Staff, Hospital; Organizational factors; Polyesters; Risk factors; Sampling; Staphylococcus infections; Uniforms; Wrist; Military nursing; Bacterial contamination; Infection prevention; Emergency department; Hospital uniform
• ISSN: 0099-1767; 1527-2966
• DOI: 10.1016/j.jen.2018.10.005

The emergency department is a fast-paced, high-volume environment, serving patients with diverse and evolving acuities. Personnel providing direct care are continually exposed to pathogenic microorganisms from patients and everyday surfaces, to which the organisms may spread. Indeed, hospital items—such as electronic devices, stethoscopes, and staff clothing—have demonstrated high rates of contamination. Despite this, policies governing the use, disinfection, and wear of various environmental surfaces remain relaxed, vague, and/or difficult to enforce. This study aimed to examine the bacterial contamination on 2 hospital uniform types in a large military hospital within the emergency department.
Environmental sampling of military and civilian nursing staff uniforms was performed on 2 separate occasions. Emergency nurses wore hospital-provided freshly laundered scrubs on the first sampling day and home-laundered personally owned uniforms complicit with ED policy on the second sampling day. Samples were collected by impressing of contact blood agar growth medium at arrival (0 hour), 4 hours, and 8 hours of wear. Microbiological methods were used to enumerate and identify bacterial colonies.
Bacterial contamination of personally owned uniforms was significantly higher than freshly laundered hospital-provided scrubs on 4 different sampling sites and across the span of an 8-hour workday. No significant differences were observed between military and civilian personally owned uniforms. However, several risk factors for nosocomial infection were increased in the military subgroup.
Re-evaluating organizational factors (such as uniform policies) that increase the propensity for pathogenic contamination are critical for mitigating the spread and acquisition of multidrug-resistant organisms in the emergency department.