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Hi
We are reviewing the headwear in our operating theatres and looking to reintroducing the cloth hats and would appreciate it if anyone had any procedures specifically looking at staff (at home) laundering and what if any instructions you provide to staff with regard to laundering of these items.
Our options are to send the hats offsite or send to our small onsite laundry, however these options have not received positive responses for many reasons.
We are keen to consider all the literature and current evidence with regard to safety and other drivers, but also conscious of the need to provide clear instructions and some sort of guidance on the required Standards before any sign off on this change in practice.
So if any of our fellow ICPs have any procedures that they can share we would be very grateful.
Cheers
KirstyKirsty Graham
Nurse Manager | CCLHD Infection Prevention and Control Unit
Clinical Safety, Quality and Governance Directorate
Level 6 (K6-COB), Gosford, New South Wales 2250
Tel (02) 4320 3382 (Internal 93382)| Fax (02) 4320 2874 |Pager 18028 |
kirsty.graham@health.nsw.gov.au or CCLHD-IPAC@health.nsw.gov.au
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Hi Kirsty,
We currently have the option for staff to wear cloth hats or disposable hats in theatre. Cloth hats are treated in the same way as scrubs and sent to the external laundry for washing after each shift.
Kind regards,
Fiona De Sousa CICP-E| Nurse Manager | Infection Prevention & Control Unit
Launceston General Hospital, Level 2, Launceston TAS 7250
phone: 6777 6715 | mobile: 0408 487 197 | fax: 6777 5170 | email: fiona.de.sousa@ths.tas.gov.au |
intranet: http://www.dhhs.tas.gov.au/intranet/thon/infection_controlIPCU – ‘By working together we promote a culture of safety to reduce preventable infections and transmission of multi-resistant organisms’
Hi
We are reviewing the headwear in our operating theatres and looking to reintroducing the cloth hats and would appreciate it if anyone had any procedures specifically looking at staff (at home) laundering and what if any instructions you provide to staff with regard to laundering of these items.
Our options are to send the hats offsite or send to our small onsite laundry, however these options have not received positive responses for many reasons.
We are keen to consider all the literature and current evidence with regard to safety and other drivers, but also conscious of the need to provide clear instructions and some sort of guidance on the required Standards before any sign off on this change in practice.
So if any of our fellow ICPs have any procedures that they can share we would be very grateful.
Cheers
KirstyKirsty Graham
Nurse Manager | CCLHD Infection Prevention and Control Unit
Clinical Safety, Quality and Governance Directorate
Level 6 (K6-COB), Gosford, New South Wales 2250
Tel (02) 4320 3382 (Internal 93382)| Fax (02) 4320 2874 |Pager 18028 |
kirsty.graham@health.nsw.gov.au or CCLHD-IPAC@health.nsw.gov.au
[cid:image001.jpg@01D5583D.2E441200] [cid:0BF7C31D82B437469D697596D7EFA393@health.nsw.gov.au] [cid:image003.png@01D5583D.2E441200] [cid:CB62CB2F3995AB4AAE7F3E9BCB84B73A@health.nsw.gov.au] Click on the hand for direct access to CCLHD IPAC Intranet SiteThis message is intended for the addressee named and may contain confidential information. If you are not the intended recipient, please delete it and notify the sender.
Views expressed in this message are those of the individual sender, and are not necessarily the views of NSW Health or any of its entities.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.
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Hi Kirsty,
I recently wrote an article in a newsletter for my clients on the topic of laundering scrubs / perioperative attire – perhaps this may be useful as a starting point?
Correct laundering of perioperative attire and uniforms
A systematic review of bacterial contamination of medical provider’s white coats and surgical scrubs was undertaken by Goyal, Sharwin et al. and published in the August 2019 edition of the American Journal of Infection Control (47: pp 994-1001).
The results of the meta-analysis indicate that attire is a potential source of bacterial transmission in healthcare settings, and whilst they could not establish a conclusive link between contaminated attire with health care associated infections, they noted that there were studies where attire was implicated in transmission of infection.
One such study that I often reference, demonstrated infectious agents can be transmitted from improperly laundered uniforms / scrub attire. This paper was published in the Journal of Infection Control and Hospital Epidemiology (Wright, Gerry et al. 2012 Vol 33, No.12 pp 1238-1241) and reported on an outbreak of sternal wound infection in 3 patients post cardiac surgery. The source was traced back to the home laundering of scrub attire in a contaminated domestic washing machine.
The meta-analysis identified a study that compared contamination rates between hospital laundered with scrubs that had been home laundered. The results showed that 44% of home laundered scrubs tested positive for coliform [read faecal] bacteria versus 0% for hospital laundered scrubs. Another study revealed that 35.7% of home laundered scrubs remained MSSA positive.
The reasons for the higher levels of bacterial contamination on home laundered scrubs is that domestic laundry practices differ from hospital or commercial laundry practices. The main difference is that hospital laundry practices require either thermal or chemical disinfection of the laundry items. Home laundry practices vary considerable as some people use cold wash cycles and if used, the warm/hot wash cycles at home do not typically achieve thermal disinfection temperatures and most people do not add bleach [disinfectant] to the laundry load.
Studies have found that the best results for eradication of bacteria are achieved when laundry is washed at high temperatures, thus achieving thermal disinfection followed by tumble drying and ironing; and this is the method of laundering recommended for hospital laundering by the Australian Standard for Laundry Practice, AS4146.
The paper provided some guidance on how to reduce the risk of spread of bacterial contamination via attire and suggested that scrubs need to be changed each workday and for staff to change into a new set when returning to the hospital setting if they have exited the hospital during a shift. Whilst the paper did not mandate that scrubs be commercially laundered; it must be noted that this is a requirement of ACORN Standards, Standard for Perioperative Attire, Standard Statement 3. This Standard states that scrubs be laundered by an approved laundry i.e. an AS4146 compliant laundry.
Many facilities have personnel that may not be required to wear scrubs and may wear uniforms. It is recommended in the meta-analysis that personnel have multiple sets of uniforms that allow them to wear clean uniforms daily and that when laundered at home, uniforms are laundered using a hot wash cycle and bleach added to the load. Washing should be followed by heated drying.
Interestingly, the NHMRC (2019) Guidelines (p. 135) states that “healthcare workers should wear a clean uniform for each shift. Uniforms should be washed at home, separately from other items. If the uniform has been contaminated with blood or body substances, the hospital facility laundry must be used”. Note that there is no guidance on what a suitable wash cycle for uniforms is given in this document.
In conclusion, clothing worn during the delivery of patient care can be a source of bacterial contamination for our patients and we must also recognise that uniforms can acquire bacterial [and other] contamination from patient care activities.
Recommendations:1 Scrub suits [and if applicable cloth hats] worn in the Operating Suite must be changed when soiled and at least daily and be laundered by a facility that complies with AS4146.
2 Staff that wear uniforms [and these may be scrub suit types] in areas outside the Operating Suite and are laundering their uniforms at home, should be advised to:
* Wear a clean uniform daily
* Launder their uniform separately to other items of clothing / laundry
* Preferably use a hot wash cycle and add bleach to the load
* Dry the uniform in a hot air dryer
ACORN also suggest that staff not store scrubs in their lockers as this poses a hazard of increased contamination of the garment.Kind Regards
Terry McAuley
Director
MSc Medical Device DecontaminationPO BOX 2249, Greenvale VIC Australia 3059
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Hi
We are reviewing the headwear in our operating theatres and looking to reintroducing the cloth hats and would appreciate it if anyone had any procedures specifically looking at staff (at home) laundering and what if any instructions you provide to staff with regard to laundering of these items.
Our options are to send the hats offsite or send to our small onsite laundry, however these options have not received positive responses for many reasons.
We are keen to consider all the literature and current evidence with regard to safety and other drivers, but also conscious of the need to provide clear instructions and some sort of guidance on the required Standards before any sign off on this change in practice.
So if any of our fellow ICPs have any procedures that they can share we would be very grateful.
Cheers
KirstyKirsty Graham
Nurse Manager | CCLHD Infection Prevention and Control Unit
Clinical Safety, Quality and Governance Directorate
Level 6 (K6-COB), Gosford, New South Wales 2250
Tel (02) 4320 3382 (Internal 93382)| Fax (02) 4320 2874 |Pager 18028 |
kirsty.graham@health.nsw.gov.au or CCLHD-IPAC@health.nsw.gov.au
[cid:image001.jpg@01D5583D.2E441200] [cid:0BF7C31D82B437469D697596D7EFA393@health.nsw.gov.au] [cid:image003.png@01D5583D.2E441200] [cid:CB62CB2F3995AB4AAE7F3E9BCB84B73A@health.nsw.gov.au] Click on the hand for direct access to CCLHD IPAC Intranet SiteThis message is intended for the addressee named and may contain confidential information. If you are not the intended recipient, please delete it and notify the sender.
Views expressed in this message are those of the individual sender, and are not necessarily the views of NSW Health or any of its entities.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.
Replies to this message will be directed back to the list. To create a new message send an email to acipclist@acipc.org.au
To send a message to the list administrator send an email to admin@acipc.org.au
You can unsubscribe manually from this list by sending ‘signoff acipclist’ (without the quotes) to listserv@aicalist.org.au
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.
Replies to this message will be directed back to the list. To create a new message send an email to acipclist@acipc.org.au
To send a message to the list administrator send an email to admin@acipc.org.au
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