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Dirty jobs

Germ-tainted bedding, towels and uniforms require prompt and attentive care to prevent the spread of pathogens. A study confirmed the ickiness of common cleaning protocols.

Dirty jobs
The Veterinary Infection Control Committee recommends that anyone doing laundry wear gloves and protective outerwear.

You can picture it. You walk into your clinic, look at the daily schedule and realize that another frantically busy day is about to begin. It doesn’t help that two people called in sick and that you are already understaffed. You look at the morning to-do list, take a big sigh and mentally begin the day.

Far from an anomaly, this scenario describes a typical morning for many people in busy small animal veterinary practices. Given the myriad things that need to be done, laundry is usually near the bottom of the priority list — that is until laundry becomes a problem.

Where Everything Starts

For many veterinary clinics, the cleaning of bedding, towels and uniforms is a necessary evil that receives minimal attention. Yet, for the reasons I will outline here, doing laundry the right way is a critically important part of being a successful hospital. By proactively assessing and modifying your hospital’s laundry protocols, you can minimize health and legal risks, and potentially increase employee morale.

Numerous studies suggest that health care workers’ uniforms can act as reservoirs of pathogenic organisms such as Staphylococcus aureus, methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE) and Clostridium difficile. How coats and scrubs are laundered and stored influences the level of bacterial contamination. In other words, how your clinic handles the laundry matters.

The Veterinary Infection Control Committee at the National Association of State Public Health Veterinarians says the risk of disease transmission is negligible when soiled items are handled correctly. The committee recommends that anyone doing laundry wear gloves and protective outerwear. To prevent cross-contamination, separate storage and transport bins should be used to divide clean and dirty laundry.

Yet for a variety of reasons, many clinics do not follow these recommended steps. Studies at human hospitals have found that the failure to protect against pathogenic transmission in laundry is common. This makes sense given all the other priorities that come with running human hospitals and animal hospitals — laundry is often an afterthought.

The inattention can come at a cost. Not having appropriate safety programs opens the door to liability if a patient suffers from laundry-related contamination.

A Deep Dive Into Dirt

At this point, you might be wondering if your laundry practices are good enough. How prevalent are pathogens in veterinary laundry? One study conducted at a veterinary teaching hospital in Canada found that in collected samples, 17.5% tested positive for methicillin-resistant staphylococci (MRS), 3.5% for MRSA and 14.0% for methicillin-resistant Staphylococcus pseudintermedius (MRSP).

Let me tell you about a pilot study conducted with eight other veterinary hospitals. I was asked by the staffing and consulting company Veterinary System Services to help collect data on the hospitals’ laundry processes and the pathogens found. Veterinary System Services paid for the analyses done at the Colorado State University diagnostic laboratory and for a student to go to each clinic and record the average time needed to complete a load of laundry. Additionally, the student asked veterinary staffs for their thoughts about laundry.

laundry pathogen testOur pilot study collected six samples and one control from each of the eight veterinary hospitals. While the controls were found to be pathogen-free, the other results — see the table at right — suggested that standard laundry procedures left pathogens behind.

The Real World

In addition to assessing pathogen contamination, we attempted to calculate the burden of laundry duties at the eight participating hospitals. They were operating at full capacity and were often short on help, so laundry was sometimes a low priority. The loads frequently piled up to the point that the laundry simply had to be done. We saw laundry rooms, not just laundry baskets, overflowing.

When talking with staff members, many mentioned that laundry tended to accumulate quickly unless it was attended to regularly. As one person explained, “If we don’t keep it moving, the laundry piles up to the ceiling within one day!” Another mentioned, “The only time the laundry is not running is overnight.”

Who handled laundry duty varied among the clinics. At most of the hospitals we observed, laundry was done primarily by veterinary assistants and veterinary technicians. Given the shortage of veterinary technicians at many hospitals, doing laundry might not be the best use of their time or the practices’ financial resources. Furthermore, I have learned that asking trained, certified technicians to do laundry likely does little to improve their morale or job satisfaction. This is important to consider given that many technicians feel unappreciated and undervalued.

What You Should Be Doing

For all these reasons, I suggest it’s time for veterinary clinics to think about alternative laundry options, or at least step up their protocols. Outsourcing laundry service might be logical for some clinics.

The following guidelines can improve laundry cleanliness:

  • Pay attention to the cleanliness of the machines, laundry baskets and folding area.
  • Launder extremely soiled items separately.
  • Don’t overfill the washing machine.
  • Set the dryer on the highest heat setting.
  • Eliminate contact between dirty and clean laundry.
  • Assess the in-clinic laundering of staff coats and uniforms. Make adjustments as needed.

Given veterinary medicine’s current level of sophistication, I recommend that we more closely examine our laundry procedures.

Dr. Lori Kogan is a professor of clinical sciences at Colorado State University.