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Hotter Than July

August 20, 2007 -- Today the Express and Star (U.K.) reported that staff at Dudley's Russells Hall Hospital said nurses were "risking the spread of superbugs by snubbing the in-house laundry service and washing their uniforms at home." The unsigned piece, "Nurses risk spreading bugs," says nurses avoid the service because it does a poor job. The piece fails to mention the risk from other hospital staff--do physicians wash all of their clothes and neckties at 70 degrees C (158 F)? But we commend the Express and Star for focusing attention on this issue, which is often overlooked by the media, by staff, and by hospitals, which should provide workable systems to control infection risks that are plainly beyond the reach of individual staff to manage. We also encourage nurses in clinical settings to urge their employers to provide uniform cleaning services and showering facilities for all staff to reduce the spread of deadly organisms from health facilities to the community.

The piece relies on unidentified "staff" at the hospital, mainly one person who says most of the nurses wash their clothes at home, at temperatures far below what is required to kill deadly "superbugs such as C-diff and MRSA." The report notes that the required temperatures are over 65C, but home washing is unlikely to reach more than 30-40C. The employee says that a lot of the nurses take the bus to and from work, which would of course bring them into contact with many more people and bacteria. The piece reports that most of the nurses don't use the "contracted laundry firm" Sunlight, because "garments are often lost or come back creased from the in-house cleaners." This employee adds that it's too bad the hospital contracts out the service, "because the hospital used to do it all themselves and it was a really good service. You could even pay and they'd do your curtains, so they even ran at a profit."

In response to all this, the piece includes quotes from the Dudley Group of Hospitals spokeswoman. But they merely restate the importance of following the policy, without addressing the problems the piece mentions. Likewise, the Sunlight Services spokesman reportedly said the firm "ran more than 50 laundries at sites across the country and had received no complaints."

Nurses certainly have more direct patient contact than others, and the piece is a helpful reminder that their infection control practice is a major factor in nosocomial infections. At the same time, nurses are not the only staff to present these risks, and the piece might have made that clear. Physician neckties, for instance, appear to be a significant reservoir for harmful bacteria. The piece might also have sought comment from a nurse (its main source may be one, but it does not say). It seems clear that a deadly infection risk that requires industrial-strength cleaning well beyond the reach of individuals also requires that hospitals provide effective, convenient cleaning systems to their staff, just as they must provide reasonable hand-washing facilities. Unfortunately, many do not.

We believe nurses should work to prevent the spread of dangerous contaminants throughout the community. To further this goal, we urge all nurses in clinical settings to ask their employers to furnish uniform cleaning services and showering facilities. That way, health workers can return to the communities and their families after work without spreading contaminants.

We thank the Express and Star for covering this important issue.

See the article "Nurses risk spreading bugs" in the August 20, 2007 Express and Star.


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