COMPTON, Calif. — Infection control might be on everyone’s radar, but it is just one factor in recent changes to healthcare apparel. Peter Menaker, regional sales manager for textile manufacturer, distributor and importer American Dawn, says there are other factors driving changes in the textile industry, too.
Menaker briefed laundry processors and linen distributors during an Association for Linen Management-sponsored webinar, Changes in Healthcare Apparel.
For healthcare workers and laundry managers, infection control can be a major concern.
“As of June 2010, Centers for Medicare & Medicaid Services stopped reimbursing for the costs of hospital-acquired infections,” he says, “so it became more important for healthcare facilities to make sure there are as few hospital-acquired infections as possible.”
Most of the concentration has been on hand-washing initiatives. “That’s been a big focus,” he says, “because most such infections are transferred on the hands of the healthcare worker. I’ve seen recently initiatives … (concerning) hospital-acquired infections that occur among catheter patients and in patients with central lines.”
Another point of interest to laundry personnel is the use of antimicrobials bonded with the fabric of patient garments.
“Antimicrobial treatments are certainly starting to show up on patient apparel, bedding, cubicle curtains, room curtains, scrubs, personal protective apparel and equipment, and certainly they’ve been found in surgical gowns for some time.”
Menaker went into depth on treatments that involve metallic ions being fused permanently onto a textile product. Silver, copper and even gold are used in these technologies.
“These metallic ions combine with a membrane that increases the surface tension of fabrics that can also make them fluid-repellent yet breathable,” he says.
The ions puncture a germ’s cell membrane, rendering it incapable of replicating. These types of antimicrobial treatments, according to Menaker, are nonleaching and permanently bonded to the fabric. He warned against using any type of treatment that works by allowing the chemical to leach from the fabric.
“If the antimicrobial is leaching out of the textile, eventually it will not be effective in killing the organisms we want it to kill,” Menaker says. “Also, it’s possible that the leaching chemical could disturb the skin (of the wearer) and cause an issue. And we don’t want to be causing an allergic reaction or any problem with their skin.”
Also, a leaching type of textile creates a zone of inhibition, which leads right to a zone in which the antimicrobial treatment is only partly effective in killing off germs.
That could lead to the microbe mutating and becoming resistant to the treatment, developing into a superbug, he says.
Antimicrobial treatments can present challenges for laundry managers.
“With any of these antimicrobial agents, we want to make sure we use a chemical and a process in our laundry that will not break the bond between this molecule and the product that we want it to stay on,” Menaker says. “And the provider of the antimicrobial textile or your laundry chemical provider should be able to let you know which processes might be necessary for use with these types of products.”
There is a staining test available that can determine if the antimicrobial treatment remains on the textile product, he says.
Another potentially problematic issue for laundries arises when items such as isolation gowns or cover gowns feature a coating that can be refreshed. Each garment has a grid stamped onto the fabric or a label attached that allows the laundry to keep track of the number of times the item has been laundered.
Most treatments can withstand a limited number of washings—usually around 75. The challenge arises when a garment has been chemically refreshed, or a treatment is reapplied to the garment. How laundry personnel communicate that the garment is once again fluid-repellent is an ongoing concern.
Reapplying the treatment could also be cost-prohibitive.
Menaker says textiles are usually not involved in hospital-acquired infections, and there is a question whether treating the textiles with an antimicrobial would truly be helpful in preventing infection.
“I don’t think there have been any studies on this, and the jury is definitely still out,” he says.
Patient satisfaction is growing as a change motivator in the industry, Menaker says. Many healthcare facilities are using Press Ganey and other survey tools to gauge how patients perceive that institution’s commitment to care.
“In fact, textiles come into patient satisfaction quite a bit,” Menaker says, “if you realize that patients have more interaction with their hospital gown and their bedding than they really have with doctors and nurses.
“They’re exposed to their textile products 24 hours a day for every day they’re in the hospital. So, like it or not, these do make an impact on how satisfied they are with their treatment at the hospital.
“Usually the laundry hears about it when a linen item is of subpar quality or in quantity. But it can also go the other way, too. If linens are upgraded, they can actually make a patient experience more positive.”
Patient dignity is another influence on healthcare apparel decisions. Religious considerations, physical size and patient mindset all go into determining how a hospital’s apparel offerings fare in a patient’s assessment of dignity issues.
Burkas and face veils have been in the press, and obesity is a concern on many different levels, Menaker says. Patients also are more involved in their own care, and patient comfort and allowing them to focus more on the care for their illness is important, too.
“We also have smaller and smaller people coming into the hospital, too, with more premature births, and there may be some issues with garments being too big or not properly sized for the little patients,” says Menaker.
And there are standardization issues to be considered, especially as they relate to supply/processing costs and effectiveness of the laundry service.
“With so many SKUs, particularly in patient gowns,” Menaker says, “there’s some cost implications in standardizing, stocking fewer different garments, and processing them properly and distributing them to the end-user.”
Tomorrow: Laundry processors need to play a role in policy changes…