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 interact 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 conversation about quality control.
What quality control components are used at a laundry and what data is collected to monitor this?
HARTSELL: This question here has two parts with it, the collection of information and what you do to monitor it. The normal information IP (infection prevention) or IC (infection control) are looking for, in my opinion, would be the standard titration type information, pH, what are you doing to monitor your wash process.
But they may want to know what you're doing above and beyond that. Are you doing ATP (adenosine triphosphate) monitoring? Are you recording that? Are you doing any other type of quality-control measures looking at your stain, your rewash, that type of thing?
So, they really want to know what you're looking at, what you're gathering, and then what KPIs (key performance indicators) you have to maybe trigger something else like additional linen purges, different formulations in your wash process, that type of thing.
They want to see what you do when it is out of normal. So, do you just show them the records that you can that track that data?
HARTSELL: Normally we have what the upper limits are before something triggers a change. If we're doing testing with our isolation gowns, there's going to be a trigger at a certain point when we increase the number of samples that we test when we start to see a certain number fail.
I know they look at it because one example would be, we sent samples to be tested to a lab and the lab was bought out by another company. The format of the paperwork changed and within a day of that new format going out to the different IC/IPs, they had questions. So, they do look at it and they are pretty keen if something does go off. But we try to put it on the different reports, and we try to put what our limits are so that it's clear.
The next question is on quality assurance. How are textiles cleaned to ensure no contamination remains from patients with infections?
MANGINI: There are a combination of a couple things we do. Obviously, whatever product you're going to wash, the first thing I do is get the IPs engaged with you that, you know, I’ll take the product and see what’s the manufacturer’s recommendation.
But then, secondly, it's the old WATCH—water, agitation, temperature, chemistry, heat—and then make sure that you're partnering with your chemical vendors making sure they're in there engaging, not just coming and checking, here's a report, and leaving. We're having discussions. What are you seeing? What are you finding?
Additionally, sending out for the validations, that third-party vendor like Jason discussed, sending out for an independent report and making sure that your spore counts are down. Do you have any biologicals left over, and if you do, what's the action plan because they’re going to ask?
We use an outside company. I want to know if laundry services that do hospital laundry are regulated in a way to guarantee acceptable quality.
MALBOEUF: From our standing, we go through healthcare laundry accreditation. Each of our facilities goes through that every three years. Each of our facilities is accredited by HLAC (Healthcare Laundry Accreditation Council).
They're following Joint Commission and they have certain protocols and tests to ensure that we're meeting the acceptable quality standards for those processes.
If we have written down a policy or procedure, we’re going to make sure we’re following that policy or procedure as well.
Check back Thursday for Part 2 with questions about privacy/cubicle curtains.
Have a question or comment? E-mail our editor Matt Poe at [email protected].