This study by Professor Liz Scott and colleagues from Simmons Colllege Boston USA is published ahead of print in Am J Infect Control. 2015 Jul 1. pii: S0196-6553(15)00530-1. doi: 10.1016/j.ajic.2015.05.007.
Eighty-nine students were recruited from October 2013-April 2014, 31.5% of whom lived on campus. Student nurses swabbed their scrub tops after clinical and after laundering, and they completed a laundry survey; 13.5% of students wore the same scrub more than once, and few followed recommended guidelines by using hot water (20%) or bleach (5.6%) when laundering scrubs.
MRSA was not detected on any of the swabs. However, 15 (17.3%) of prelaundry swabs tested positive for MSSA. Of those positive prelaundry, 9 (64.3%) were negative after laundering, but 34.7% (6) were positive i.e survived the laundry process. There was no significant reduction in MSSA after laundering (McNemar test, P ¼ .27). There were no statistically significant differences in clearance of MSSA after laundering by hot water use, dryer time, bleach use, or ironing.
The lack of association between laundry practices and MSSA clearance may have been caused by being underpowered and not because they do not have benefit in clearing contamination. However, considering a U.S. student nurse population of >300,000, they calculated that >50,000 MSSA-contaminated student nurse scrub tops could be leaving clinical settings with 17,000 still contaminated after laundering.
The authors concluded that “nurse educators should include safe laundry practices in foundations of nursing courses. One responsibility is preventing transmission of infection, and safe laundry practices are important in that effort. Nursing students should be taught to change out of scrubs immediately after their shift to prevent potential cross-contamination to other surfaces in the school and community”.