Top 10 Hidden Infection Prevention Dangers and How to Fix Them (Part 2)

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. Last time, we looked at hidden dangers one through four. This time, we’ll explore numbers five through seven.

5. MOIST TEXTILES LEAVING THE PLANT

I love the healthcare laundry axiom: “Getting healthcare textiles clean is straightforward, but the true test lies in ensuring they remain clean until they reach the patient.”

Illustrating this axiom, textiles leaving the laundry plant while still moist or damp pose a significant infection risk.

There are several methods for drying healthcare textiles:

Tumble Drying: Utilized in healthcare facilities for its efficiency, tumble dryers employ hot air circulation to remove moisture. Commercial-grade dryers with features like moisture sensors ensure thorough drying.
Air Drying: Some textiles are air-dried by suspending them on lines or racks, aligning with eco-friendly practices but potentially extending drying times.
Flatwork Ironing: High-capacity systems like flatwork ironers handle certain types of flatwork textiles, providing drying and pressing in a single step.
Steam Pressing: Used for finishing and drying specialty textiles like cubicle curtains and lab coats.

Precision in the drying process hinges on rigorous attention to detail. Factors like textile type, initial moisture content, load size, drying device temperature and drying time are critical.

Mishandling these variables can lead to undesirable outcomes, from excess moisture retention to product damage.

Overdrying results in damaged linen or uncomfortable patient wear, escalating costs and a larger environmental footprint.

Conversely, underdrying fosters an environment conducive to pathogen growth, increasing infection risks and compromising patient safety.

Mastering optimal textile drying requires focus on key areas:

Follow Manufacturer Guidelines: Adhere to laundering and drying guidelines provided by textile manufacturers.
Sort Textiles: Categorize textiles based on fabric type, color, and soil level to ensure even drying and prevent damage.
Control Load Sizes: Tight control of load sizes ensures efficient drying in tumble dryers.
Invest in Proper Equipment: Commercial-grade equipment with features like moisture sensors ensures optimal drying conditions.
Monitor Drying Times: Set appropriate drying times to prevent fabric damage or excess moisture retention.
Perform Equipment Maintenance: Regular maintenance ensures equipment functions efficiently and reduces fire hazards.
Prioritize Equipment Hygiene: Develop and enforce a rigorous equipment hygiene program to prevent lint and dust accumulation.
Measure and Monitor Drying Results: Implement a process monitoring program to check finished textiles regularly and promptly address any issues.

By focusing on these areas, healthcare facilities can ensure optimal drying outcomes, minimize infection risks and uphold patient safety standards.

6. INADEQUATE PROTECTION OF CLEAN TEXTILES DURING TRANSPORT

Despite our efforts to maintain cleanliness in the finished healthcare linen staging or storage area, transporting clean linens inevitably exposes them to potentially unclean environments.

Whether from the laundry to the hospital or the patient room, clean linens may traverse areas prone to contamination, including shared delivery vehicles with soiled linens.

Functional and physical separation must be upheld during transport to safeguard against outside contamination.

To mitigate risks, it’s crucial to diligently protect clean linens during transport. This typically involves covering linen carts with fluid-proof polyethylene or cloth covers, ensuring full coverage without tears or gaps.

Additionally, lining cart bottoms with a barrier prevents ground splashes from reaching clean linen.

When transporting clean and soiled linens together, efforts should be made to physically separate them, with soiled linens stored in fluid-resistant containers. Securely anchoring all carts in the vehicle prevents spillage.

Personnel training is essential, emphasizing proper bagging and placement of textiles in the transport vehicle. Staff handling soiled textiles must adhere to standard precautions to minimize contamination risks.

7. CONTAMINATED AND UNCLEAN SURFACES

In healthcare, surfaces that come into contact with cleaned healthcare textiles, like those in laundries, pose a threat to patient safety if contaminated.

The transfer of harmful pathogens compromises the integrity of linens and medical textiles, increasing the risk of HAIs and directly endangering patient well-being.

To address this issue, rigorous cleaning protocols and the use of smooth, washable surfaces are essential. Based on my observations in numerous hospitals and laundry facilities, several common surface risks have been identified.

Porous materials used for work surfaces, such as unsealed wood, cardboard, rusty metal, or concrete, can absorb and retain contaminants, hindering effective cleaning.

In both laundries and hospitals, porous surfaces in direct contact with clean linens present contamination risks. Common scenarios include:

Use of sticky tape for labeling carts, which cannot be adequately cleaned and should be avoided on surfaces exposed to clean linens.
Wooden discharge tables, often found at the end of ironers or piece folders, pose contamination risks to clean linens.
Clean carts with wooden bases may lead to contamination of the textiles they carry.
Cardboard boxes on the finish floor can harbor pathogens, risking contamination of clean textiles.
Unsealed concrete floors or walls in the finish area may pose contamination risks if clean textiles come into contact with them.
Torn or worn conveyor belts used in laundry operations become porous and uncleanable, posing contamination risks.
Surfaces with rough or textured finishes can trap contaminants, complicating cleaning efforts.
Damaged countertops or tables with cracks or crevices can harbor contaminants, compromising cleaning and disinfection.
Laundry carts with intricate designs or hard-to-reach corners present challenges for cleaning and disinfection.

Addressing these concerns requires careful material selection and equipment maintenance. Stainless steel and polypropylene plastic are recommended for their resistance to microbial growth and ease of cleaning.

Additionally, exploring emerging technologies such as self-cleaning and antimicrobial surfaces is advisable.

Implementing stringent cleaning policies and providing staff training are crucial for maintaining hygiene standards. Validation and documentation of proper cleaning can be achieved through visual inspection, ATP testing, surface swabbing, microbiological testing, and the use of fluorescent markers or tracers.

Click HERE to read Part 1 with dangers numbers one through four. Check back Thursday for the final three hidden infection dangers.