Nurses (& the like) wearing scrubs outside the workplace.

augustsmummy

snugglepet20 wrote: »

It was a bit ironic considering some of the patients that came in clearly had ingrained dirt on them and hadn't had a good wash for quite some time!

I'm not sure if I have miss understood this post (forgive me if I have) but I fail to see any irony here.
Your patient, regardless of how clean you percieve them to be deserves to be protected from hospital aquired infections as much as the next person.
You can't always tell by looking what bacteria someone is carrying, if you could our job would be a heck of a lot easier.

And given the intimate proceedures that are carried out in an endoscopy (and ?colonoscopy ) department I think I would welcome such strict policies, well done that trust.

brook2jack

Caroline73 wrote: »

I'm a nurse. I wear my uniform to and from work but that's it. I don't make any detours on route. I wear a clean uniform each day despite only being given two uniforms when I sometimes work 5 days a week.

My trust has a very strict uniform policy and they do discipline for anyone found outside in uniform. Exceptions are travelling in private transport to work.

The research indicates that after one days wear over 50% of uniforms are contaminated with antibiotic resistant strains of bacteria, that rises so by day two or three virtually 100% is contaminated with an resistant bacteria. You should be given enough uniforms to wear clean every day.
Since uniform needs to be washed at at least 60 to remove contamination it must be difficult to run that many hot washes a week.
I hope all who wear uniforms claim the tax allowance for washing their clinical wear , it's about £100 a year.

There really should be a country wide policy on this ,applicable to everyone , the same as in dentistry where we have htm 01 05 cross infection rules we are inspected on and can be shut down if we don't follow and ditto for food manufacturers. I really find it strange that someone can make a vegetable pie which will be cooked at home and have more stringent clothing regulations than the nurse changing the dressings on a leg ulcer on a diabetic 80 year old .

kiss_me_now9

In my local it's strictly forbidden to wear ward clothes outside the hospital (for doctors too) and as the hospitals Unison rep, my mum's always having to defend people for it. Not sure of the logic behind it myself, I suspect it's for image reasons rather than actual hygiene reasons.

mr_rush

There is no evidence to suggest wearing hospital uniforms outside / to&from hospital increases rates of infection.

The rest is just speculation...

brook2jack

Actually if the nothing below the elbows got this sort of result then clothing as a vector for infection spread seems to be fairly well proven. As lack of hand washing is still a problem but more specifically hands can be washed during the day, clothing can't.

"Doctors no longer wear white coats at a hospital, as part of a drive to reduce the spread of infections. The scheme, trialled at Torbay Hospital in Devon for 18 months, is expected to be rolled out across the UK by the NHS. Doctors and all clinical staff are not allowed to wear anything on their arms below the elbow to enable them to wash their hands more efficiently. Bosses said the regime has contributed to a 50% cut in MRSA rates and a 60% reduction in Clostridium difficile. There has also been a 60% reduction in the number of cases of over the past 12 months."

Some interesting extracts re contaminated clinical clothing http://tahilla.typepad.com/mrsawatch/clothing_hygiene/

mr_rush

brook2jack - the only thing that has been shown to reduce infection rates is washing your hands. bare below the elbows does not have any significant effect. wearing the same clothes in hospital to your home has no statistical effect.

i have discussed this in detail with various microbiology professors.

brook2jack

Actually I have also discussed this with many colleagues, Microbiologists and cross infection colleagues as cross infection is a very hot and expensive topic in dentistry despite the fact dentists unlike doctors and nurses have no higher a carriage rate of ab resistant bacteria than the general population, most ,if not all , dental proceedures cannot be described as high risk and we deal with a healthier population.

However in common with our medical colleagues we come in close contact with large numbers of the general public and their various bugs.

Even before the recommendations for not wearing clinical clothes and footwear outside the practice came in I always changed.... why because I wasn't prepared to cuddle my babies in my work clothes and there is no way I would carry out the rigorous cross infection cleaning at home that goes on in the surgery.

Research shows cloth carries viable bacteria and viruses. Research is going on to investigate if clothing does indeed act as a reservoir. As not wearing clinical clothing outside is a cost free or cheap exercise in cross infection control, even if the effects are only psychological is that small investment not worth it to prove to staff and public alike that all practicable measures to prevent cross infection are being carried out? It makes far more sense than eg some of the expensive and dangerous measures that were taken post CJD eg disposable tonsillectomy instruments.

mr_rush

I would welcome links to peer-reviewed journals.

Apollonia

mr_rush wrote: »

I would welcome links to peer-reviewed journals.

HTM 01-04 might be out soon but I wouldn't hold my breath, the original publication date was 2 1/2 years ago.

According to this reply to a FOI request it should be this month:

http://www.whatdotheyknow.com/request/htm_01_04_decontamination_of_lau?unfold=1

The draft document is now undergoing a review based on comments received
in response to the consultation. Subject to approval, the Department
intends to publish the completed document on the Space for Health website
([1]www.spaceforhealth.nhs.uk) in March 2012.

brook2jack

Actually the problem with htm 01 05 is alot of it is NOT based on peer reviewed papers.
Mr Rush pub med run a good search but these papers are about contamination of clinical clothing (nurses a bigger problem than doctors, who are a bigger problem than dentists)

As you know there are no good studies yet about contaminated clothes being proven as a a source of infection but studies are under way.


This article cites some older studies http://infection-control.net/z/index.php?option=com_content&view=article&id=54&Itemid=60

but this Iraeli study is from the end of last year http://www.medpagetoday.com/HospitalBasedMedicine/InfectionControl/28359

if you read the original article the longer the uniform worn , the higher the chance of HAI bacteria occuring.