West Gordon F, Resendiz Marisol, Lustik Michael B, Nahid Md A
J Emerg Nurs. 2019 Mar;45(2):169-177.e1. doi: 10.1016/j.jen.2018.10.005. Epub 2018 Dec 17.
The emergency department is a fast-paced, high-volume environment, serving patients with diverse and evolving acuities. Personnel providing direct care are continually exposed to pathogenic microorganisms from patients and everyday surfaces, to which the organisms may spread. Indeed, hospital items-such as electronic devices, stethoscopes, and staff clothing-have demonstrated high rates of contamination. Despite this, policies governing the use, disinfection, and wear of various environmental surfaces remain relaxed, vague, and/or difficult to enforce. This study aimed to examine the bacterial contamination on 2 hospital uniform types in a large military hospital within the emergency department.
Environmental sampling of military and civilian nursing staff uniforms was performed on 2 separate occasions. Emergency nurses wore hospital-provided freshly laundered scrubs on the first sampling day and home-laundered personally owned uniforms complicit with ED policy on the second sampling day. Samples were collected by impressing of contact blood agar growth medium at arrival (0 hour), 4 hours, and 8 hours of wear. Microbiological methods were used to enumerate and identify bacterial colonies.
Bacterial contamination of personally owned uniforms was significantly higher than freshly laundered hospital-provided scrubs on 4 different sampling sites and across the span of an 8-hour workday. No significant differences were observed between military and civilian personally owned uniforms. However, several risk factors for nosocomial infection were increased in the military subgroup.
Re-evaluating organizational factors (such as uniform policies) that increase the propensity for pathogenic contamination are critical for mitigating the spread and acquisition of multidrug-resistant organisms in the emergency department.
急诊科是一个节奏快、工作量大的环境，为病情多样且不断变化的患者提供服务。提供直接护理的人员持续暴露于来自患者和日常表面的致病微生物中，这些微生物可能会传播。事实上，医院物品，如电子设备、听诊器和工作人员服装，已显示出高污染率。尽管如此，关于各种环境表面的使用、消毒和穿着的政策仍然宽松、模糊且/或难以执行。本研究旨在检查一家大型军队医院急诊科内两种医院制服类型上的细菌污染情况。
在两个不同的时间对军队和文职护理人员的制服进行环境采样。在第一次采样日，急诊护士穿着医院提供的刚洗过的工作服，在第二次采样日，穿着符合急诊科政策的在家洗过的个人制服。在穿着到达时（0小时）、4小时和8小时后，通过按压接触血琼脂生长培养基收集样本。使用微生物学方法对细菌菌落进行计数和鉴定。
在4个不同的采样部位以及8小时工作日期间，个人制服的细菌污染显著高于医院提供的刚洗过的工作服。军队和文职个人制服之间未观察到显著差异。然而，军队亚组中几种医院感染的危险因素有所增加。
重新评估增加致病污染倾向的组织因素（如制服政策）对于减轻急诊科多重耐药菌的传播和感染至关重要。
