Uniform: an evidence review of the microbiological significance of uniforms and uniform policy in the prevention and control of healthcare-associated infections. Report to the Department of Health (England)

Wilson, Jennie; Loveday, Heather; Hoffman, Peter; Pratt, Robert

doi:10.1016/j.jhin.2007.03.026

Cited by 125 publications

(87 citation statements)

References 24 publications

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“…Despite this, the Working Group and the British Medical Association recommended that white coats should not be worn when providing patient care and that shirts and blouses should be short-sleeved. 1 Recent evidence-based reviews concluded that there was insufficient evidence to justify this policy, 3,22 and our data indicate that the policy will not decrease bacterial or MRSA contamination of physicians' work clothes or skin.…”

Section: Discussionmentioning

confidence: 69%

“…2 Interestingly, the National Health Service report acknowledged that evidence was lacking that would support that white coats and long-sleeved garments caused nosocomial infection. 1,3 Although many studies have documented that health care work clothes are contaminated with bacteria, including methicillin-resistant Staphylococcal aureus (MRSA) and other pathogenic species, [4][5][6][7][8][9][10][11][12][13] none have determined whether avoiding white coats and switching to short-sleeved garments decreases bacterial contamination. We performed a prospective, randomized, controlled trial designed to compare the extent of bacterial contamination of physicians' white coats with that of newly laundered, standardized short-sleeved uniforms.…”

mentioning

confidence: 99%

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Newly cleaned physician uniforms and infrequently washed white coats have similar rates of bacterial contamination after an 8‐hour workday: A randomized controlled trial

Burden

Cervantes

Weed³

et al. 2011

Journal of Hospital Medicine

107

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BACKGROUND:Governmental agencies in the United Kingdom and Scotland have recently instituted guidelines banning physicians' white coats and the wearing of long‐sleeved garments to decrease nosocomial transmission of bacteria.OBJECTIVE:Our aim was to compare the degree of bacterial and methicillin‐resistant Staphylococcus aureus contamination of physicians' white coats with that of newly laundered, standardized short‐sleeved uniforms after an 8‐hour workday and to determine the rate at which bacterial contamination of the uniform ensued.DESIGN:The design was a prospective, randomized controlled trial.SETTING:The setting was a university‐affiliated public safety‐net hospital.PARTICIPANTS:One hundred residents and hospitalists on an internal medicine service participated.INTERVENTION:Subjects wore either a physician's white coat or a newly laundered short‐sleeved uniform.MEASUREMENTS:Bacterial colony count and the frequency with which methicillin‐resistant Staphylococcus aureus was cultured from both garments over time were measured.RESULTS:No statistically significant differences were found in bacterial or methicillin‐resistant Staphylococcus aureus contamination of physicians' white coats compared with newly laundered short‐sleeved uniforms or in contamination of the skin at the wrists of physicians wearing either garment. Colony counts of newly laundered uniforms were essentially zero, but after 3 hours of wear they were nearly 50% of those counted at 8 hours.CONCLUSIONS:Bacterial contamination occurs within hours after donning newly laundered short‐sleeved uniforms. After 8 hours of wear, no difference was observed in the degree of contamination of uniforms versus infrequently laundered white coats. Our data do not support discarding long‐sleeved white coats for short‐sleeved uniforms that are changed on a daily basis. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine.

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Section: Discussionmentioning

confidence: 69%

mentioning

confidence: 99%

Newly cleaned physician uniforms and infrequently washed white coats have similar rates of bacterial contamination after an 8‐hour workday: A randomized controlled trial

Burden

Cervantes

Weed³

et al. 2011

Journal of Hospital Medicine

107

View full text Add to dashboard Cite

show abstract

“…Por outro lado, não apontam diferenças entre o uso de água aquecida ou não para a lavagem das vestimentas. Enfatizam, também, o papel da secagem da roupa e o ato de passar a ferro, dado que o calor reduz ainda mais a contaminação presente (11) . O Staphylococcus aureus representa o patógeno mais Rev Bras Enferm.…”

Section: Discussionunclassified

“…Sabe-se que os jalecos tornam-se contaminados pela microbiota do usuário, principalmente abaixo da cintura e após procedimentos com risco aumentado de exposição a patóge-nos como, troca de curativos, por exemplo. O que poderia ser minimizado pelo uso de coberturas ou aventais plásticos descartáveis (11) . Portanto, pelos dados expostos referentes à contaminação dos jalecos em uso de apenas quatro horas em atividades hospitalares e a importância epidemiológica representada pela presença de S. aureus resistente à vancomicina, parece ser de suma importância discutir-se quais medidas podem ser desenvolvidas de maneira a minimizar o potencial patogênico representado por estas vestimentas.…”

Section: Discussionunclassified

Microbial contamination of cuffs lab coats during health care

Margarido¹,

Boas²,

Mota³

et al. 2014

Revista Brasileira De Enfermagem

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RESUMOO estudo objetivou avaliar a contaminação bacteriana em jalecos de acadêmicos de enfermagem após a sua utilização em práticas assistenciais à saúde. Realizou-se estudo quantitativo e descritivo, no qual os jalecos dos acadêmicos foram recolhidos, lavados e passados de forma padronizada e usados durante quatro horas em atividades assistenciais. Subsequentemente, coletaram-se amostras dos punhos com hastes de algodão estéreis para serem incubadas; analisando-se posteriormente o crescimento microbiano por meio de análise morfológica pelo método Gram e antibiograma. Observou-se crescimento bacteriano dos microrganismos Staphylococcus aureus e Staphylococcus epidermidis em 50% das amostras coletadas, sendo que o Staphylococcus aureus, encontrado no ambulatório de atendimento a portadores de feridas, apresentou resistência aos antibióticos Vancomicina, Cloranfenicol e Sulfonamidas. Os dados demonstraram que os jalecos utilizados durante as atividades assistenciais, mesmo em curtos períodos, são contaminados por cepas resistentes a antibióticos e que potencialmente podem ser causadores de infecção relacionada a assistência à saúde. Descritores: Staphylococcus Aureus; Enfermagem; Infecção Hospitalar. ABSTRACTThe study aimed to evaluate the bacterial contamination in lab coats worn by nursing students, before and after being worn in health care practices. A quantitative and descriptive study was carried out, in which the students' coats were collected, washed and ironed in a standardized way and wore for four hours in assistance activities. Subsequently, samples from the cuffs were collected with sterile cotton swabs in order to be incubated in order to analyze microbial growth through morphological analysis by Gram's Method and antibiogram. There was bacterial growth of Staphylococcus aureus and Staphylococcus epidermidis in 50% of the collected samples and Staphylococcus aureus, found in patients with wounds in outpatient care, showed resistance to antibiotics such as Vancomycin, Chloramphenicol and Sulfonamides. The data demonstrated that the lab coats wore during assistance activities, even in short periods, are effectively contaminated by strains resistant to antibiotics and can potentially cause infection related to health care. Key words: Staphylococcus Aureus; Nursing; Cross Infection. RESUMENObjetivó-se evaluar la contaminación bacteriana de batas de laboratorio de estudiantes de enfermería, antes y después del uso en la asistencia a la salud. Realizó-se un estudio cuantitativo y descriptivo, en el que fueron recogidas las batas de los alumnos, lavadas y planchadas de manera estandarizada y usadas durante cuatro horas en actividades de asistencia. Seguidamente, se recolectaron muestras de los puños con hisopos de algodón estéril para ser incubadas; analizando-se posteriormente el crecimiento microbiano mediante análisis morfológico por el método de Gram y el antibiograma. Hubo crecimiento bacteriano de microorganismos Staphylococcus aureus y Staphylococcus epidermidis en 50% de las muestras recolectadas, s...

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“…31 A recent study 16 demonstrated that bacteria, including MRSA contamination, occurred at similar levels on newly laundered short sleeved uniforms and physicians' white coats, with no difference found in contamination of the skin at the wrists of physicians wearing either garment. Bacterial contamination was found to occur within hours of putting on uniforms, so by three hours, nearly 50% of the organism total count after eight hours was already present.…”

Section: So Which Infection Prevention and Control Interventions Matter?mentioning

confidence: 99%

Wearing white coats and sitting on beds: why should it matter?

Hill

2011

Clinical Medicine

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Uniform: an evidence review of the microbiological significance of uniforms and uniform policy in the prevention and control of healthcare-associated infections. Report to the Department of Health (England)

Cited by 125 publications

References 24 publications

Newly cleaned physician uniforms and infrequently washed white coats have similar rates of bacterial contamination after an 8‐hour workday: A randomized controlled trial

Newly cleaned physician uniforms and infrequently washed white coats have similar rates of bacterial contamination after an 8‐hour workday: A randomized controlled trial

Microbial contamination of cuffs lab coats during health care

Wearing white coats and sitting on beds: why should it matter?

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