ATLANTA — The Association for Linen Management (ALM) fields many questions from infection preventionists (IP) regarding the processing and handling of healthcare textiles.
The association posed several of these questions, along with audience queries, to three experts during its Laundry/Infection Prevention Forum at The Clean Show here in 2022.
The healthcare laundry experts who have interacted with IPs regularly included Jim Mangini, director of linen services for Maine Medical Center; Jason Hartsell, vice president of operations for United Hospital Services; and Chip Malboeuf vice president of engineering and operations for ImageFIRST.
Former ALM Executive Director Linda Fairbanks moderated the session, and what follows are some of the highlights from the final questions in the conversation.
Why are some linens cleaned, but an EKG sticker or even leads are stuck to them? Are actual people looking through these linens?
MALBOEUF: Yes, but it’s humans, so mistakes do happen. Our policy is that our associates are trained on our quality standards to inspect each item before they feed it. Do things get by? Yes. So, if an associate finds these types of things at a feeding machine, we have multiple buckets at the station for stain, rewash, other items, glue, stickers, that go into a stain rewash.
Unfortunately, removing that is a very manual process. Some people think it’s a very easy process, but there’s scraping involved, pre-treat with some type of chemical to soften the glue then it goes through stain wash. We go through a very stringent stain wash process. We inspect that to give it a final chance. There is a process we go through to make sure stain wash is properly treated and we get it back to you properly.
HARTSELL: And what I've always found is that a question like this is usually something from someone that's never been in your laundry facility. They don't realize the process involved in it. We always try to pull them back in if you start hearing a complaint about I'm seeing a lot of tape, bring them in for a tour.
We show how everything works in there, and we take them in front of the ironer or you can take them in front of a folder and encourage them to feed pieces. You just fed five pieces in a minute, and you're not making rate plus you didn't do any quality checks. You just fed a piece with a big stain on it. Their eyes kind of light up and they’re like, oh, okay, I kind of understand.
Usually, we get this question when we start to work with a very small facility that had an on-premises laundry and they're moving to a commercial facility. We start talking to the administrators or the laundry personnel, and we realize that they were at one point in time they had two people folding a thermal blanket doing 60 pieces an hour for two people. And you know, there's a reason why you guys came to us versus you keep paying somebody to spend an hour on 60 blankets.
Are personal washers acceptable to use in a hospital setting for laundering privacy curtains, bedspreads, linens, etc.?
HARTSELL: This is one a lot of times that after they come in to tour the facility and they realize just maybe how inadequate their little washer is, a little personal washer that they have at home and they also have it in the NICU ward, how inefficient that really is to not only wash but monitor and use the proper chemicals and all this other stuff.
You're relying on a human to put the right amount of detergent in. And really you only have an option of detergent or detergent. Maybe you can add an oxidizer to it, but you have no control and you probably are not going to hit the right temperatures with it. There's no monitoring of it. If your hot water shuts off, it’s going to run cold water. So, I think it really scares a lot of people when they start to kind of think about it.
And a lot of times, it's kind of like The Wizard of Oz behind the curtain, you know, we're not going to look over there to see how they're doing it. From our standpoint of a commercial laundry, it's not sufficient. There are not enough controls and processes in place to ensure that.
What are some strategies for dealing with inspectors who require you to wash 160 degrees for 25 minutes, especially that new inspector?
MANGINI: It's educating. It's bringing them the best practices we’ve always used and going back to the washroom schematic. Bringing up your independent lab reports.
It's the trying to educate them along and showing them what the wash temperatures are going through, we go up to 155-160, and showing them the actual process.
MALBOEUF: It's an education process and sometimes that can be the most challenging part of this. For us it’s going back to the wash pie—time, temperature, mechanical action and chemistry—and then sharing with them this is the type of disinfectants we use, the EPA registration that kills 99.99% of pathogens. That type of data is what we share with them, and even as commercial we send laboratory testing to have our product brand tested by each location.
HARTSELL: I found that if you try to have a group of ICs/IPs together, some people lose their braveness if they were by themself. So, I always try to have a group come in. It's a little more successful.
It could be a little more difficult if you’re a large plant to have a group of four or five different systems or hospitals. But a lot of times, you can spin it off as a networking event for them. They can meet some people and a lot of times, you'll have that one really experienced IC/IP that's been in your facility multiple times, and they're comfortable with you, they know that you're doing everything you can to do it right.
Because all of us here are trying our best to do the right thing. Nobody's out there consciously trying to reduce my temperature, my wash process down, 5 degrees to save a little bit on utilities. We want to do the right thing.
I’m sure that you saw a reduction in people taking tours and doing the inspections during COVID. And then when we spun back up, there were a lot of new faces, new people coming in. So, we lost a lot of momentum and those relationships that we had with those former IC/IPs out there.
Click HERE to listen to Part 1 with questions about quality control. For Part 2 on privacy/cubicle curtains, click HERE.
Have a question or comment? E-mail our editor Matt Poe at [email protected].