CHICAGO — There are many studies that examine contamination and sanitary linens. These include past research, current inquiries and there will be studies conducted in the future.
Most are high-quality, objective studies, says Gregory Gicewicz, president of Sterile Surgical Systems in Tumwater, Washington, and past president of the Healthcare Laundry Accreditation Council (HLAC).
“Typical focus areas include the efficacy of the laundry process in removing pathogens and the epidemiology of healthcare associated infections (HAIs) s attributed to laundered healthcare textiles,” he says. “Other more recent research focuses on antimicrobial treatments and residues for healthcare textiles.”
“TRSA continues to build the largest database of results from routine microbiological testing of destination healthcare textiles (HCTs) in North America,” says Joseph Ricci, president and CEO of TRSA, the association for linen, uniform and facility services. “The 150-plus Hygienically Clean Healthcare certified laundries are on a quarterly sampling regimen.”
Dr. Christian Mechel, product manager, environmental economics, Hohenstein Institute, says the organization continues investigations of the surfaces of wet and dry laundry, microbiological analysis of raw and soft water, and “investigation of the effectiveness of disinfection using bioindicators reduction by seven log levels of Staphylococcus aureus and Enterococcus faecium.”
What does this constant research mean for healthcare laundry operations? It’s important to stay on top of the research and to be vigilant about maintaining sanitary laundry from the plant to the patient.
Laundry work hits home hardest when laundry employees see the impact of their work on sick hospital patients, says Gicewicz.
“A finish employee may view the gown she is folding as one of a thousand inanimate objects that go somewhere that she does not care about,” he says. “Now go to a critical care part of a hospital and observe a critically ill patient wearing the gown that you processed, while lying on the bedding that you handled, in the room that was cleaned using the microfibers that you processed and delivered earlier.
“Laundry workers that witness the criticality of their work in patient safety are much more likely to view their work as a higher calling rather than just a job. Give them this opportunity by taking them to see their work in action.”
Regularly train laundry employees on the highest standards for infection prevention, Gicewicz recommends. Important topics in this training should include bloodborne pathogens, personal protective equipment (PPE), linen inspecting, wash chemistry, cart cleaning, cart protecting, environmental cleaning, environmental testing, safe linen handling and more.
He also recommends testing employees on the training, having them date and sign the training, and retaining the training records.
“The entire laundry process should be trained, hazards for employees (personal protection) and recontamination of laundry (product protection),” adds Mechel. “Not only the laundry staff but also the cleaning staff and service drivers are to be trained.”
Laundry operators must realize that opportunities for HCT contamination can occur anywhere in the process and must be diligently guarded against, cautions Gicewicz.
“Producing hygienically clean HCT requires much more than a good wash process,” he says. “Getting HCT cleaned in the wash is a complicated process requiring precision. Keeping them clean until point of use can be even more challenging.”
Gicewicz recommends laundries look for opportunities for contamination after the wash process and mitigate all of them. It only takes one contamination occurrence to result in an infection. Trace the entire journey from dryers to conveyers, to tubs, to finishing equipment, to employee hands, to linen carts, to delivery vehicles, to loading docks, to linen rooms, to linen closets, to patient rooms.
“Factor in environmental factors along the journey, including air humidity, air temperature and air cleanliness,” he adds. “Remember, bacteria thrive in moist, warm environments. Wet HCT, even in dry environments, can become contaminated. Hot textiles that are covered will cause condensation when cooled. Test for contamination in all areas on the journey and protect clean HCT at all times from contamination.”
Ricci adds that addressing laundry sanitation concerns is not exclusively a healthcare issue.
“While more than 150 laundries have earned the Hygienically Clean Healthcare certification, another nearly 100 have achieved the Hygienically Clean designations for food safety, food service and hospitality,” he shares. “Food manufacturers are especially concerned about laundries’ use of HACCP, including solid surface (ATP) testing at CCPs, to ensure risk is minimized at each.
“As more laundries earn the food service and hospitality designations, more restaurants and hotels appreciate the value of further risk reduction in laundry even when this risk is tiny.
“For all customers, but moreso for healthcare facilities and especially hospitals, laundries’ concern for producing hygienically clean textiles should extend to how these end users handle these items so they remain clean when customers begin to use them.”
The key is for operations to stay up to date on laundry sanitation issues, constantly evaluate their plants and products (both internally and via third-party testing), and, finally, to be vigilant about communication and training.
“Ensuring proper cleanliness includes hygiene training of employees, keeping order, cleaning and hygiene plans,” shares Mechel. “Also, separation of clean and dirty laundry areas, locks for transport and people between the zones, no crossing of materials and staff routes (employees should not commute between zones), and provision of disinfectants in dispensers at places in the plant where the employee really needs them.”
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