Overcoming Infection Prevention Failures (Conclusion)

CHICAGO — Healthcare laundries play a pivotal role in infection prevention, yet the industry faces persistent challenges in maintaining cleanliness standards.

With patients’ health and lives at stake, it is critical to address these challenges head-on.

American Laundry News communicated with three healthcare laundry experts to examine common pitfalls, their causes and actionable solutions for achieving and sustaining high standards of infection prevention.

In Part 1, Edward McCauley, president and CEO of United Hospital Services in Indianapolis, and an editorial advisory board member, covered chemical and formulation failures. John Hopper, the director of quality for ImageFIRST Healthcare Laundry Specialists headquartered in King of Prussia, Pennsylvania, covered the challenges of maintaining cleanliness.

In the conclusion, Gregory Gicewicz, president and CEO of Compliance Shark in Lacey, Washington, which works alongside facilities in healthcare to prevent infections, meet accreditation and certification requirements, and create a safe patient environment, examines standards and operational oversight.

STANDARDS AND OVERSIGHT

For Gicewicz, the most frequent shortcomings in healthcare laundries involve insufficient monitoring of process compliance, poor segregation of clean and soiled linens, and lapses in maintaining equipment hygiene.

“These failures often stem from a lack of rigorous standards enforcement, inadequate training, and inconsistent oversight,” he says

Specific problem areas include:

Functional Separation Deficiencies: Due to flaws in plant architecture or insufficient processes, pathogens from soiled areas can migrate into clean zones, contaminating freshly laundered linens. Mishandling of soiled linens during collection, sorting and transport further aggravates this issue.
Inadequate Equipment Maintenance: Washers, dryers, feeders, folders, ironers, compressors, fans, carts and more can become reservoirs for microbial growth if not cleaned and disinfected regularly.
Human Error: Employees may unknowingly bypass critical procedures, such as wearing appropriate personal protective equipment (PPE) or adhering to hand hygiene protocols. Furthermore, they may neglect cleaning protocols due to more pressing immediate issues.
Lapses in Final Product Inspection: Clean linens that are not inspected for stains, odors, dampness, or damage before packaging can compromise infection prevention efforts.

Gicewicz says several factors make it challenging to maintain cleanliness in a healthcare laundry plant:

Complex Workflow: The sheer volume of linens processed daily increases the likelihood of errors, particularly in high-stress environments.
Invisible Risks: Microbial contamination is not visible to the naked eye, making it harder to identify and address.
Resource Constraints: Limited staffing, outdated equipment and inadequate budgets can undermine compliance efforts.
Knowledge Gaps: Without thorough training, employees may not understand the implications of lapses in hygiene and infection prevention.
Environmental Challenges: High humidity, heat and airflow in laundry facilities can create conditions favorable for microbial growth.
The Nature of Linens: Healthcare linens, by their fibrous, linty nature, are huge spreaders of contamination, especially when agitated by machinery or human hands.

“Enhancing infection prevention requires a holistic and systematic approach to environmental hygiene,” Gicewicz points out. “This encompasses the cleanliness of the physical plant (walls, ceilings, floors, air handlers and surfaces), thorough equipment maintenance (washers, dryers, feeders, folders, vehicles), and robust staff hygiene practices.”

To help achieve thorough cleanliness, he recommends laundries:

Establish Rigorous Cleaning Protocols: Develop and implement detailed cleaning protocols tailored to high-risk areas such as sorting stations, conveyors, feeders, air handlers, folders, ironers and linen carts. These protocols should clearly define the frequency, methods and approved cleaning agents for pathogen elimination. For instance, high-touch surfaces should be disinfected multiple times daily with hospital-grade disinfectants.
Enhance Employee Training: Provide comprehensive training on cleaning protocols, ensuring it is role-specific. Document each training session, including the date and trainer. Production workers should focus on cleaning their immediate areas, while maintenance staff should receive training on deep cleaning and equipment maintenance. Delivery drivers must be trained on vehicle-cleaning protocols.
Document Cleaning Activities: Maintain detailed records of all cleaning activities using paper or electronic checklists. Ensure these records are easily accessible for audits or reviews.
Perform Routine Audits: Regularly conduct visual inspections and microbial testing of equipment, surfaces, air, water and linens. These audits not only identify issues early but also evaluate the effectiveness of cleaning protocols, ensuring continuous improvement in hygiene standards.

Employees are the frontline of infection prevention in healthcare laundries, shares Gicewicz, and comprehensive training and oversight programs are essential. To achieve this, he says laundries should:

Develop a Structured Training Program: Educate employees on the science of infection prevention, emphasizing the importance of their roles. Include hands-on demonstrations and refresher courses.
Certify Competencies: Require employees to pass certification tests demonstrating their understanding of SOPs (standard operating procedures) and infection prevention principles.
Foster a Culture of Accountability: Create an environment where employees feel responsible for the cleanliness and safety of their work.
Utilize Technology: Implement systems for tracking employee adherence to protocols, such as touchless handwashing stations, hand hygiene monitoring systems, automated PPE dispensers, smart PPE tracking systems, and smart badges or wristbands to provide reminders to employees when entering high-risk areas.
Encourage Open Communication: Provide channels for employees to report potential issues without fear of reprisal.

Gicewicz adds that to maintain high standards of cleanliness, healthcare laundries should adopt a holistic approach that incorporates:

Collaboration with Infection Prevention Experts: Partner with healthcare infection preventionists to align laundry practices with hospital standards.
Adherence to Industry Standards: Follow guidelines from organizations such as the Healthcare Laundry Accreditation Council (HLAC) and the Centers for Disease Control and Prevention (CDC).
Ongoing Research and Innovation: Stay informed about emerging technologies and practices, such as whole genome sequencing (WGS), to identify and eliminate pathogens.
Customer Education: Work with healthcare facilities to ensure they understand the importance of proper linen handling and storage post-delivery.
Investing in Quality Assurance Programs: Regularly review and update quality assurance initiatives to reflect advancements in the field.

CONCLUSION

“Healthcare laundries are a cornerstone of infection prevention, but the path to excellence requires vigilance, innovation, and commitment,” Gicewicz says.

By addressing common pitfalls, investing in employee training and leveraging advanced technologies, the industry can overcome barriers to cleanliness and ensure the highest standards of infection prevention.

“As emphasized in (my upcoming book) Invisible Risks: The High Stakes of Healthcare Linen Compliance, every step in the laundry process matters because patients’ lives depend on it,” Gicewicz concludes.

Click HERE to read Part 1 about chemical/formula shortcomings and maintaining cleanliness.