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Top 10 Hidden Infection Prevention Dangers and How to Fix Them (Part 1)

First four areas of concern for healthcare laundries to address

TACOMA, Wash. — Have you looked into the investigation report of a plane crash? 

Typically, such reports uncover a complex interplay of mechanical and human factors rather than a solitary cause. Most reveal a convergence of system failures and pilot errors, despite modern aircraft being engineered with numerous safety redundancies. 

Crashes, though rare, underscore the importance of constant vigilance.

Now, let’s contemplate the rigorous process of ensuring the cleanliness of healthcare linens, like a simple 10-cent washcloth. While seemingly distant from safely navigating a multimillion-dollar passenger airplane, parallels emerge on closer examination. 

Just as in aviation, where any lapse can lead to dire consequences, a single misstep in the linen production process can result in severe infections for patients. 

Both industries share a common imperative: the pursuit of perfection in every action to safeguard lives and well-being.

Consider the potential pitfalls along this journey. For instance, improper containment of a washcloth post-patient use at the hospital could contaminate surfaces, risking healthcare-associated infections (HAIs). 

Similarly, if washed with the wrong formula or handled by an employee with food spills on their uniform, contamination persists, endangering patients. 

Each oversight amplifies infection risk for hospital patients, emphasizing the critical importance of meticulous hygiene throughout the linen handling process.

We’ve merely scratched the surface; the potential for contamination on this journey is vast. 

Let’s explore deeper the top 10 infection prevention risks in a healthcare laundry and how to fix them. This time, we’ll explore the first four on the list.


During a recent inspection at a healthcare laundry, I encountered a disconcerting sight: a linen room, meant to be pristine, was cluttered with dirty dishes atop a clean linen cart. 

It was reminiscent of a reckless game, pushing boundaries with non-medical items. Such negligence highlights the critical need to uphold impeccable hygiene standards in areas housing clean linens. 

Any lapse can lead to contamination, jeopardizing patient safety and impeding staff efficiency. Maintain cleanliness rigorously, enact thorough cleaning protocols, and ensure diligent monitoring to safeguard both patients and professionalism.


Picture this scenario: a housekeeper about to spread a flat sheet on a hospital bed uncovers a large stain, or a patient at a women’s health clinic slips into a robe emitting an unpleasant odor—a harbinger of dangerous bacteria. 

These examples underscore the grave consequences of unclean linen, often resulting from lapses in infection prevention and patient safety standards.

It’s important to investigate how these linen items, meant for patient use, became tainted. Was there a fault in the initial wash process, or did contamination occur post-wash?

Our primary task is to trace the root cause of the issue, starting from the wash process itself. 

Testing linens post-wash is crucial; visible stains or unpleasant odors may indicate inadequate cleaning. 

Modern washers, though complex, operate on a simple principle: water, chemicals, heat, mechanical action, and time collaborate to cleanse and disinfect linens. If cleaning falls short, one or more of these components may be malfunctioning.

Conduct thorough checks; ensure wash temperatures are optimal, boilers are functioning correctly and chemical concentrations are accurate. 

Verify proper water levels and load sizes and confirm mechanical operations like drum rotation and extraction. Seek expert assistance if needed.

Once the root cause is identified, corrective action must be taken and rigorously tested. 

It’s crucial to ensure that the solution works consistently over time. Regular monitoring, including chemical titrations and linen testing, is essential to maintain desired standards.

If the wash process proves sound, attention must shift to downstream contamination. Make sure linens are protected from all contamination sources (e.g., air, hands, surfaces, etc.) during the rest of the journey to the patient. 


Functional separation in infection control entails strategically dividing functions, processes or areas within healthcare settings to prevent infection spread. It aims to establish distinct zones or protocols to minimize cross-contamination risk and enhance infection prevention. 

Maintaining proper airflow is crucial, ensuring higher air pressure in clean areas than in dirty areas to prevent dirty air from infiltrating clean spaces. Common issues compromising airflow include open bay doors, turned off air handlers and incorrect airflow in certain areas. 

For example, bay doors opening during cart drop-offs disrupt airflow, leading to cross-contamination. Solutions include installing heavy plastic strips or enclosed staging rooms for soiled goods. 

Similarly, employee actions like turning off air handlers on cold days disrupt airflow, which can be mitigated by implementing policies restricting access to air handler controls.

Inadequately sized air handlers can result in inconsistent airflow across the plant, causing hidden gaps where dirty air flows into clean areas. Properly sized handlers ensure uniform air pressure throughout the facility. 

Continuous airflow monitoring is essential, preferably using electronic systems or visual indicators like streamers. 

Regular checks and record-keeping ensure swift action in case of airflow discrepancies.


The laundry’s small wash deck often escapes scrutiny for cross-contamination risks. 

This area houses conventional washers and dryers, handling smaller or specialized loads. Typically, in a room equipped with washers and dryers, the process involves loading dirty linens, washing, drying and finally moving clean linens to the finish area.

However, the risk arises when clean linens encounter dirty ones, leading to cross-contamination and infection hazards. To address this, strict procedures and training are paramount. 

Implement protocols ensuring that dirty linen carts enter the small wash deck only after clean linen carts have exited, reinforced by clear signage and visual aids. For instance, using a “Walk/Don’t Walk” sign system can denote the area’s status, guiding operators accordingly. 

Clean, disinfected carts must remain segregated from dirty ones at all times. Emphasize a foolproof process to prevent cross-contamination, complemented by comprehensive operator training.

Check back Thursday for numbers five through seven on the hidden infection danger list.

Top 10 Hidden Infection Prevention Dangers and How to Fix Them

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Have a question or comment? E-mail our editor Matt Poe at [email protected].