Chemicals Supply: Carrie Armstrong, Ecolab, Eagan, Minn.:
Washing of the linen is only one part of the process of providing clean linens for storage. Each stage in the linen flow cycle from wash, finishing, transport, storage and point of use involves various opportunities for contamination of linen if proper training, cleaning and procedures are not enforced.
Be sure to clean transport or distribution carts with a hospital-grade disinfectant prior to loading the carts with the clean linens. Cover the carts to keep the linens from airborne contaminants. Enclosing the linen from the bottom up helps keep the linens clean, depending on the cart manufacturing. If it’s a mesh-like cart, the wheels can kick up dirt, water, etc.
Covers used for the clean linen require routine cleaning. A hard-surface cover can be wiped down with a hospital-grade disinfectant cleaner; a soft-surface cover may be washed. If the storage room is dry and clean with proper airflow and does not have much personnel traffic, cleaning frequency would be less than if storing in an area such as a hallway or dock area with more potential for airborne dirt and human contact. Wherever the storage may be, cleaning and disinfecting procedures—for the carts, floors, vents, covers, and general area—are necessary.
Routine hand washing for personnel transporting the clean linen and distributing the linen helps prevent contamination. Providing waterless hand sanitizers in transport trucks and storage areas or in closets for use prior to transporting linen carts or touching the linen helps keep the linens clean.
Evaluate the transport route from drop-off of the laundry to the storage area, including time from drop-off to storage and location of stopping points during the transportation process. If clean-linen carts are dropped off at an outside dock area and not attended to for an extended period of time, there is potential for the linen and/or the carts and covers to become contaminated. It is important that the clean linen is transported to the clean, dry storage area in as short a time as possible.
Conduct routine education and training on the importance of hand washing, cleaning, transporting and keeping aware of what the linens may be exposed to. Install hand-sanitizing stations and posters in areas where the clean linens are transported and stored. Train, educate, and issue continual reminders of how important it is to keep the linens clean in the facility. It is a team effort, from the laundry to the point of use.
Healthcare Laundry: Michael Kirsch, CLLM, HCSC Laundry, Allentown, Pa.:
In the healthcare laundry business, the wash process is only one step for providing hygienically clean linens for patient care. How clean linen is handled once it has been laundered and processed is critical in today’s healthcare environments.
With the many antibiotic-drug-resistant microorganisms that invade our environment today, maintaining clean linen is essential for good patient care. Proper handling and distribution of clean healthcare linens is crucial for the patient.
Within the laundry, processed clean linens need to be placed in properly sanitized linen-distribution carts. Prior to loading clean linens in these bulk-linen carts, each cart should be lined with properly sized plastic liners. These protective liners help to contain the linen from exposure.
When the cart is fully loaded, the plastic liner should be securely knotted. This further ensures that clean linens are fully contained during transport. This method of packing and transportation protects the textiles from physical damage and minimizes microbial contamination from surface contact or airborne deposition.
Just like the clean-linen transportation vessels, delivery motor vehicles must also be cleaned and sanitized prior to the loading and securing of clean-linen carts for transport.
Once received at the healthcare institution, clean linens need to be stored in a clean-linen room or storage area. The plastic cart liners should only be opened as linen items are needed for replenishment, or for loading fresh unit carts for distribution throughout the healthcare facility. Properly sized and secured cart covers should always be used to protect the clean linens during internal transport, as well as to protect them from improper handling and contaminants.
Even after all these measures have been taken to ensure that healthcare patients always receive fresh, clean linens, caregivers often place piles of clean linen in chairs, on bedside tables, and on windowsills just to save a few steps in their daily routine. When this is done, the chain of supplying clean linen for the patient is then broken. That’s pretty sad when you think of all that we in the laundry business do to try to supply hygienically clean linen for their patients.
Uniforms/Workwear Manufacturing: Scott Delin, Fashion Seal Healthcare, a Brand of Superior Uniform Group, Seminole, Fla.:
Recently, my son came home from college and brought with him a present for my wife—a large, plastic laundry basket overflowing with his dirty laundry. After the basket was emptied, my wife, a nurse practitioner in neurology, immediately took several disinfectant wipes and began the long-overdue task of wipe-down and cleaning of the dreaded plastic laundry basket.
While watching this, I was reminded of the necessary procedures that should be automatic, everyday protocol within our laundries when processing linen, textiles and uniforms for our customers. As laundry owners and/or managers, it is our duty and obligation to constantly deliver clean, sanitized, soil-free products to our customer base.
As managers, we go to great lengths to ensure we are processing clean linen, textiles and uniforms. This includes implementing needed steps so no cross-contamination occurs on the clean side once the product is processed. For starters, we need to:
- Process our soiled linen in a separate area from our clean linen
- Process using chemicals that are more friendly to our environment
- Mandate procedures on our soiled-linen side that will reduce waste and have an impact on our carbon footprint
- Outfit the employees throughout our facilities in crisp, clean uniforms and gloves to help reduce the possibility of any type of cross-contamination of bacteria onto the clean product
- Strive to keep our plants clean
Prior to delivering clean product to our customers, we need to make sure the cleanliness of our product remains intact by poly-bagging the uniforms and linen. It is important that all clean products, once processed, are stored in a designated area that is far from the soiled area.
Our fleet also plays an important role in ensuring the delivery of clean products. Steps and procedures need to be implemented and monitored to make sure the bins and hampers used for transporting product to the end-user are cleaned on a daily basis. Trucks also need to be kept clean of trash and bacteria.
Many plants today are also looking to the Healthcare Laundry Accreditation Council (HLAC) and the Textile Rental Services Association (TRSA) to have their processing plants inspected and to undergo an accreditation process to ensure and demonstrate that their plants meet the demands of our industry and those of customers for hygienically clean products. For more information on this process, I would strongly suggest contacting HLAC or TRSA.
While the healthcare market is changing and we’re constantly looking for ways to make ourselves better, we need to keep in mind that in order to be successful, we must be vigilant in mandating procedures to ensure we are processing and delivering clean products to our customers.
Equipment Manufacturing: Gary Ostrum, G.A. Braun, Syracuse, N.Y.:
Taking a couple steps back in the process, it is important that the statement starts with “properly washing and drying linens.” The storage and transportation of linen becomes a moot point if the linen is not processed to a hygienically clean state. Hygienically clean means “free of pathogens in sufficient numbers to cause a human illness.”
If the mission is to deliver linens that meet this standard, then the processed linens must meet the standard once dried. Their condition will not improve downstream during the storage/delivery process. Technically, the only way to confirm this is through sample testing. While testing a base set of samples may not confirm that processes in place are being accomplished 100% of the time, testing will at least show that the washing/drying processes used in a facility have the ability to produce hygienically clean linen.
With a process now in place that identifies the product is hygienically clean, what can we do to keep it that way? It starts with people. First are the operators coming into direct contact with the linens, who should follow proper hand-washing procedures and handling processes and be in good health themselves.
Maybe the timing was right for this panel question, but recently a study came out regarding the transmission of norovirus in the food service industry. The article identified the most common causes of transmission as ill employees coming into work, or improper hand-washing procedures.
To some level, the same applies to operators in a laundry. Are we making sure our employees follow proper hand-washing procedures? Are we training our staff to know that we do not want them coming to work if they are ill, and sending them home if they show up for work sick? Do these policies extend to apparel policies? There are a host of regulations to protect staff from soiled-linen conditions. What are we doing to protect the linen from the staff?
Working to reduce direct-contact handling of linens once they are cleaned is part and parcel of this process. Material handling of finished linens has evolved to a high level in our industry and is available for the processing of everything from garments to stacks of sheets. But sooner or later, someone is handling the linen, and if one institutes and maintains proper clean-linen handling processes, one does not have to incur the expense of not having such processes.
The poly-wrapping of linen is commonly seen in F&B plants and certainly provides an effective barrier as linen is handled and transported. What happens to all this poly-wrap may be a “green” concern to some, and if the linens being wrapped are damp or wet, the storage of these linens in a non-permeable-type wrapping may lead to a mold/mildew condition.
With that, we are left with common sense and the basic principles of storage and transportation of linens used for decades.
Clean linen is always transported in a covered container designated as “clean.” This designation comes from a documented cleaning process the container goes through before clean linen is put in it. If it can be shown the container is a “clean only” container, it may not have to be cleaned after each use, but a documented process for keeping the “clean only” container clean needs to be identified.
Storage of linen is another matter. As noted earlier, linen put away damp could develop an issue during storage. Also, linen in a pack that may have a stain or other substance not removed in the wash process could lead to issue in storage.
But as far as I know, the only regulations regarding the shelf life of linen and the need to reprocess it involve linen designated as “sterile.” So if linen is stored in the same clean designation process that one follows with transportation, I would say linen could be stored for a pretty long time and retain a clean designation.