ROANOKE, Va. — Sooner or later every manger will be faced with the problem of a new, mysterious stain that starts showing up in the laundry. 

The first challenge, if you service more than one institution, is to determine where the stain is coming from. If it is caused during the delivery of excellent healthcare, it is likely that the problem will spread from one institution to another. 

The first thing to realize is that you are not alone. If you are having this problem, then it is a certainty that someone else is experiencing the same problem.

The first step to finding a solution is to determine what items the stain is appearing on. Work with your employees to determine the range of textile products that are affected. 

Then, develop an accurate description of the stain both before and after it is washed. Is the stain identifiable before the item is washed? Is there an odor associated with it? Does the stain have an oily or greasy feel? A full description of the problem, including photographs, is most helpful. 

Once you know which items are affected and have an accurate and complete description of the stain, the next step is to publish on an industry message board about your stain. The chances are high that someone else has experienced that problem and knows where it comes from and any possible alterations to processing that might lessen the problem. 

If you are truly lucky, you might be the first person to have run into this problem, and you will need to take the following steps to determine the source. Start with your list of items that are affected. Are they hospital-wide items, or are they used by only one department? The wider the potential range of linen items affected, the more likely it falls into a stain that comes from a topical disinfectant. 

Approach your hospital contact if you are an outside service, or bring the problem to the attention of your boss if you are an in-house laundry. 

The initial goal is not to place blame or make anyone feel like they have done anything wrong. The goal is to determine the source of the problem so you and your chemical supplier can develop an effective treatment for the problem. 

Remember, the goal is to provide excellent healthcare to the patients. That is the goal of everyone involved in the healthcare industry. Unfortunately some products that are highly effective as a disinfectant also can cause a staining problem. 

Your process is to eliminate potential sources of the problem by a thorough and careful examination of the products used in the hospital. Approach your research by examining broad methodologies for treating patients. 

Never ask about specific treatments to specific patients because this would violate HIPAA regulations. You do not need to know about Mrs. Jones’s medical treatment specifically, but you would like to know about the current bed bathing procedure for patients. If you can isolate the problem to a particular type of patient, then understanding the normal treatment procedures for that type of patient would be very helpful. 

I would recommend starting with topical disinfectants and bed/bath products to determine if any items in this category are causing your problem. I find normally working with a member of the infection control staff at this point to be very helpful. 

I would need to obtain a small sample of each product used in the hospital. Take those samples back to the laundry and apply them to specific locations on various textile products to see if the product causes the new stain.

If it turns out to not be in this category, then it is likely a medicinal stain, which makes isolating the source of the stain very important. Medicinal stains are normally caused by a group of patients with a specific diagnosis. 

Why should you go through all this work to identify the source of a stain, and how will that help me properly handle the problem? These two questions will be answered in next month’s article.