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Nurses uniforms one of biggest threats to infection prevention

29 April 2014

Failures in infection control in the NHS highlighted by NICE are not the fault of nurses, doctors or any one individual in the UK healthcare system, The Textile Services Association (TSA) has said.

In a statement, the association said that it believes that the system itself is at fault as it ignores one of the biggest threats to patients: infection via nurses' uniforms. TSA is calling on the NHS to recognise this risk and to do something about it.

The association said: "One only needs to review the reaction to media coverage of the NICE report by Prof Gillian Leng to ascertain that training in infection control and hygiene is high priority, but time pressure and the NHS working environment conspires against best practice and creates double standards. It is the same with rules around nurses’ uniforms."

Research by the Textile Services Association and similar bodies in Europe indicates that factors such as hand washing are just one part of the problem of infection control. It has found that a serious threat to patient safety stems from nurses uniforms, because nurses are carrying potentially harmful infections both into the hospital and then back into the home at the end of the working day.

The hygiene standards in a hospital kitchen, or even a dog food manufacturer, can be higher than those required for the cleaning of a nurses’ uniform, the TSA says. "The food industry does not wait to find evidence that contamination arose at a certain point before it does something about it. At every point it asks: 'what are the risks of product contamination'; and then it implement the controls and monitoring needed.”

The crux of TSA’s argument is that the Department of Health guidelines allow nurses to wash their uniforms at home in totally unsuitable domestic washing machines.  Domestic machines do not reach or maintain the degree of temperature necessary to remove bacteria picked up during a nurse’s working day, let alone their travel to and from their place of work.

Britain is almost the only European country that tolerates the infection risk posed to patients and the public by home-washed uniforms worn by nurses in, and travelling to and from, their work place, the TSA says. It highlighted this situation in a report in 2011, but says that the risk of infection from nurses’ uniforms continues unchecked.

Therefore, the TSA is calling for an urgent review of current policy and the adoption of a system allowing for the professional laundering of uniforms in a controlled environment to remove risk of infection and to prevent recontamination after laundering.

The TSA said: "To build on the 2011 report and to achieve our aims we need to undertake further research to prove our point and we want to work with all of the stakeholders."

It concluded: "For effective change to occur healthcare professionals – especially senior management in the Department of Health and NHS Trusts – have to pull together with work wear experts, the RCN and interest groups similar to our own. Together we can undertake the appropriate research, trials and tests to prove our argument and to change the current guidelines and the current system of infection control.

"If we cannot do that then 300,000 people will continue to develop an infection while being treated by the NHS and we will have done nothing to mitigate one of the biggest risks to patient safety in the British healthcare system."