Identifying Infectious Contamination of Military Uniform in a Hospital Setting

Background:  Annually, approximately 2 million nosocomial infections occur with approximately 90,000 patients dying as a result of these infections. Nurses may unintentionally carry bacteria on their attire. The Army uniform may play a role in nosocomial infections as the sleeves hamper adequate hand hygiene and the Velcro may stick to isolation gowns increasing the potential for self-contamination during removal. Finally, the frequency of laundering and methods used may be inadequate to adequately clean the uniform.  

Research Question(s) or hypothesis (es):

1. Compare the degree of bacterial contamination of the military uniform to surgical scrubs in nurses working in an inpatient setting.
2. Compare the degree of bacterial contamination of the military uniform to surgical scrubs in nurses working in an outpatient setting.
3. Describe the laundering practices of nurses who wear a military uniform to work.
4. Describe and compare the hand hygiene practices of nurses who wear a military uniform to those who wear surgical scrubs.

Design: Cross over, randomized experimental method.

Sample: Military nurses providing direct patient care within Tripler Army Medical Center.   

Method: A Wilcoxon rank-sum test will be used to assess differences in colony counts.  Repeated measures conditional logistic regression analysis will be used to assess whether percent of positive MRSA/ VRE cultures differs between military uniforms and surgical scrubs.  Descriptive statistics will summarize hand washing and laundering habits. A significance level of p 0.05 will be used for all analyses.

This research will quantify the bacterial contamination of the military uniform compared to surgical scrubs. Nosocomial infections are militarily relevant as bacteria common within Iraq and Afghanistan have been identified in both patients returning from theater and in patients with no exposure to these countries. This highlights the role of cross-contamination related to nosocomial infections unique to military healthcare.