Infection Control and Laundry Operations

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(Image credit: Alissa Ausmann)

“More and more, I’m hearing about laundries and infection control. How concerned should I be about this? Are there steps I can take to, as much as possible, ensure my textiles are clean?”

Long-Term Care Laundry, Kathrine Flitsch, Wheaton Francsican Healthcare, Brookfield, Wis.

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Kathrine Flitsch

Kathrine Flitsch

In our facility, we work very closely with our infection control nurse. Being aware that potentially all laundry we come in contact with should be considered infectious, we make sure we have safeguards in place.

Our laundry is bagged at the point of use and placed into hampers that are lined with leakproof bags and have lids. The hampers are used to transport the soiled laundry to the linen chute on the unit. By doing this, we are able to contain any spores or microorganisms within.

Our facility takes steps to ensure that the routes that our soiled and clean laundry take do not cross paths at any point. We transport the clean and dirty laundry in their own separate carts, which have the sole purpose of transporting that type of laundry. Using covered carts to transport the clean clothing back to our patients helps to reduce possible contamination.

When storing clean linen, keep the room as clean as possible. The room should have a door that can be kept closed. If your linen is kept on the unit, make sure it is covered and kept in an area that is away from dining areas and patient care areas. When storing clean linen, be certain it is not on the floor and that the area it is in can be readily cleaned on a regular basis, and not sitting on a cart in the hallway for all to rummage through.

We have separate areas to handle the soiled linen and clean linen, both on the units and in the laundry processing area. Our associates use personal protective equipment when handling soiled laundry to prevent cross-contamination. Our clean-laundry area and the clean-laundry room are kept as free of dust as possible. We also disinfect our folding table throughout the shift.

When doing our patients’ laundry, many things are considered when choosing the best detergents for processing the laundry. Selecting the right detergent is important because a harsh variety may cause skin irritations and a mild variety does not inactivate microorganisms that may be present in the laundry. With the many choices of detergents on the market, you should be able to find one to meet the needs of your facility.

Our washing machines are programmable based on what is in the load. By being able to use those features, we are able to control the amount of detergent, water temperature and length of cycle to maximize the precision cleaning we desire for our laundry. Routine maintenance on dryers and washing machines will ensure the end product is the best we can offer our patients.

By taking a few steps such as educating those who work with the laundry, as well as the caregivers on the units, on the importance of clean linen, we can make sure that our patients are getting the quality they deserve each day.

Chemicals Supply: Scott Pariser, Pariser Industries Inc., Paterson, N.J.

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Scott Pariser

Scott Pariser

While always a concern, infection control, and its relation to linen processing and handling, is more critical than ever with the advent of globalization and an ever-increasing array of exotic and resistant strains of bacteria.

In approaching this month’s question, it is important to make the distinction between cleaning and disinfection.

In the process of laundering, linens are first cleaned, which essentially involves the neutralization and removal of soil with alkaline builders and surfactants, and then sanitized, which is generally accomplished through a combination of hot water, related pH changes, adequate time and the appropriate use of a bleaching agent.

This distinction is important because it is not uncommon for linens that have been properly cleaned in the wash aisle to be less than hygienic at point of use due to contamination during the finishing process or from exposure to pathogens during or after the linen is transported out of the laundry.

Good washing practice, especially in the healthcare laundry, begins with common-sense handling precautions and proper soil sorting. These procedures, inclusive of the use of appropriate clothing/gloves, protect laundry workers from bacterial infection while ensuring that linens are effectively and economically processed according to their respective needs.

The workplace surrounding the wash process needs to be clean and uncluttered; the possibility of cross-contamination of soiled and clean linen must be eliminated. Airflow in and out of the washroom should be analyzed with respect to potential airborne-pathogen transfer.

Hygienically processed linens require thoughtfully constructed wash formulae and washing equipment that is routinely evaluated for proper water levels and hot-water temperature control. Dryers must be cleaned daily to prevent contamination of the airflow, and linen transportation carts must be routinely cleaned and sanitized with an EPA-registered disinfectant. 

Linen carts, once loaded, should be covered, and if the linen’s use is going to be delayed over an extended period of time, the use of a bacteriostatic softening agent should be considered in the wash process, which will impart a self-sanitizing residual that provides a zone of bacterial inhibition on processed goods while they remain in storage. The effectiveness of the bacteriostatic agent can be quantified by sending linen samples out for independent analysis of sanitary score and zone of inhibition.

In summary, good hygienic linen is important for end-user safety and requires proper handling procedures in combination with routine/scheduled maintenance of washing, finishing and linen transportation systems. The importance of this regimen cannot be overstated, and its disciplined implementation should be an integral part of every laundry manager’s purview. 

Textiles: Steve Kallenbach, ADI American Dawn, Los Angeles, Calif.

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Steve Kallenbach

Steve Kallenbach

Infection control is surely one of the major new frontiers in our precious industry, and both healthcare and food-and-beverage operators are mostly well aware of the dynamic. The growing need for laundry-driven infection control safety is a result of a) the real-life need, b) the growing understanding of the professionals within healthcare and foodservice, and c) the growing understanding of the general public.

Healthcare-acquired infections (HAI) are likely driving the dynamic to the buying public. HAI is the result of a patient entering a healthcare facility for treatment of a symptom and then contracting another infection from within the healthcare facility. The real driver here is actual deaths that have occurred as the result of HAI. While most of the public doesn’t really know the data here, some healthcare agencies have stated that deaths resulting from HAI are approaching 400,000 annually.

Additionally, foodservice-related infections are all over the news when they occur, as they impact a number of people all at once. When food poisoning and death occur as the result of people eating at restaurants, CNN tells us all the information, and suddenly the general public is looking for answers and action. How concerned should a laundry be about this? Very. Are there solutions? Yes.

In the healthcare arena, there are certifications that can help operators be “safe” with the processing and ultimate delivery of their linens. The Healthcare Laundry Accreditation Council (HLAC) will give operators guidance on certification and the steps to ensure safer “product.” The Textile Rental Services Association’s (TRSA) Hygienically Clean certification will give operators guidance on certification and the steps to ensure safer “process.” NSF International has also deployed a Hygienic Laundering certification and is actively focused on “public health and safety.”

It is likely that within a few short years, operators won’t be able to effectively retain present clients and/or gain new clients in this market without a credible certification. There are many experts who can assist operators through equipment, chemistry, working space, textile handling, finishing and packaging, but rest assured, the time is upon our industry to take this seriously.

With the growth of social media and the conscious understanding of the buying public, as well as the power of purchasing transitioning to millennials (who are tapped into the information stream), our industry is approaching a market that will require credibility to the buying public before the first appointment.

Foodservice linen cleanliness is a newer dynamic in the industry, mostly as the result of highly publicized events. The restaurant market has been long aware of the need and has taken responsible action for years with their rating system. However, there is legislative movement on this front, to keep the public safer, with regard to cleanliness standards.

On the food preparation front, the FDA and USDA have been active in the area of safety for many decades. Bottom line is that every time we have a foodservice-related “mass incident,” the public becomes more aware. Couple that with the information stream from the healthcare front and we are converging on a time when the buying public simply wants to know they are safe. The U.S. public eats in restaurants now more than ever, and when they eat at home, they use packaged goods now more than ever.

TRSA is initiating a Hygienically Clean certification with standards in the food and beverage market. NSF International’s Hygienic Laundering certification is focused on “public health and safety.” Larger restaurants and foodservice chains will soon become more aware of these certifications, which will drive the market to seek credibility during the purchasing process.

HLAC, TRSA and NSF have slightly differing approaches to certification, and there is activity between them to bring more standardization. So, as an operator, should you pay attention to this area? Yes. Get involved, learn the market dynamics, get the information and take action. It’s the right time, and beyond all of the above, it’s the right thing to do—to take the socially responsible steps to ensure clean and safe textiles for our buying public.

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