Nurses’ uniforms: off the radar. A review of guidelines and laundering practices

There is historical and contemporary evidence that nurses’ uniforms, clothing, linen and inadequate laundering processes have been the primary source of healthcare associated infections (HAI). This theme is explored here using published scientific, social science and expert commentary. The relevant themes identified in the literature include: transfer of HAI via uniforms, clothing and linen; hospital laundering processes; home laundering processes and lack of guidelines on maintaining and laundering nurses’ uniforms. The literature reveals a disparity between hospital and home laundering practices, inconsistencies in current infection control guidelines and a lack of guidelines on maintaining and laundering nurses’ uniforms. Importantly, what is absent in the literature is the concept that nurses’ uniforms can act as a secondary source of HAI, acting as a reservoir to recontaminate clean hands. This has a direct impact on the outcomes of national hand hygiene programs. Despite the identified risks, Australia lacks any clear guidelines for nurses or healthcare institutions on how to maintain or launder uniforms to decrease this risk of HAI.