Infection Control on Linen and Laundry Management

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LINEN ANDLAUNDRY

MANAGEMENT

ROSAFE E. PERALTA, RN, MANChief Nurse

MARYMOUNT HOSPITAL


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INTRODUCTION

Patient-care delivery workeris often the person thought

of rst; when it comes toprotecting hospitalpersonnel from the

transmission of infectiousdiseases


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INTRODUCTION

Infection control

practitioners must be awarethat the handling ofhealthcare facility laundry

and linen poses risks toanother population ofhospital worker.


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INTRODUCTION

Laundr !ers"nne#areresponsible for processinghundreds of thousands ofpounds of contaminatedreusable linens annually andcan be at risk for injury ifprecautions are not taken


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INTRODUCTION Infection control consultant Raymond tero!

Ph"! former director of academic a#airs forthe $ational %ssociation of Institutional &inen'anagement ($%I&')

*Infection control manuals should be writtento allay fears regarding the processing ofcontaminated linen! and adds that if commonsense procedures -- dictated by +tandard

Precautions (+P) -- are followed! the chanceof disease transmission is ,almostnoneistent.


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RELATED LITERATURE $

,ospital laundry workers -- anat-risk group for hepatitis %/,

0org and Portelli (2333) related the eperiences of 44

laundry personnel at +t. &uke5s

ospital in 'alta! who weretested for seropositivity tohepatitis %.


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RELATED LITERATURE $

6hey were matched with 78nursing aides working in

pediatric and infectiousdisease wards! who were usedas controls.

Ig9 antibodies were found in:.: < of laundry workers and27.: < of nursing aides


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RELATED LITERATURE $ &aundry personnel consistently

handling dirty linen prior to washingshowed an increased risk as compared

with colleagues handling only cleanitems.

6he results suggest that the increasedeposure of hospital laundry workers

to potentially infected linen canconstitute a risk of occupationalhepatitis % for this group of

employees.


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RELATED LITERATURE % *$osocomial transmission of

+almonella gastroenteritis to laundryworkers in a nursing home=

+tandaert! utcheson and +cha#ner(233)

$osocomial transmission of

+almonella gastroenteritis to laundryworkers in a nursing home in a rural6ennessee county were eamined.


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RELATED LITERATURE %

Residents and sta# of the nursing home wereinterviewed and cultures of stool sampleseamined for enteric pathogens.

+tool cultures from 74 residents and >employees were positive for +almonella hadar.

Infection among the residents was foodborne!&u' infe('i"n a)"n* e)!#"ees #i+e#

re!resen'ed se("ndar 'rans)issi"n! asnone of the employees ate food prepared inthe kitchen and their onset of symptomsoccurred seven to 2? days after that of ill

residents.


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Three #aundr !ers"nne# h"had n" ("n'a(' i'hresiden's

ere infe('ed. 'ost of the ill residents (>2


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Laundr !ers"nne# re*u#ar# a'e in'he #aundr r""), did n"' ear!r"'e('i-e (#"'hin* and did n"' ear

*#"-es ("nsis'en'# hi#e hand#in*s"i#ed #aundr.

6he researchers concluded that linen

soiled with feces was the source ofnosocomial +almonella adar infection inlaundry workers and underscore theimportance of using appropriate

precautions when handling linen.


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The Cen'ers f"r Disease C"n'r"#and Pre-en'i"n CDC/0sGuide#ines f"r Laundr inHea#'h(are Fa(i#i'ies

,%lthough soiled linen has beenidentied as a source of large numbers

of pathogenic microorganisms! the riskof actual disease transmission appearsnegligible. Rather than rigid rules and

regulation! hygienic and common-sense storage and processing of cleanand soiled linen are recommended.,


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CONTAMINATEDLAUNDRY

,laundry which has been soiledwith blood or other potentially

infectious material or maycontain sharps. @1#""d&"rnePa'h"*en S'andardissued by

the O((u!a'i"na# Safe' andHea#'h Ad)inis'ra'i"nOSHA/2


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CONTAMINATEDLAUNDRY

+% says healthcare facilitylaundry poses eposure to blood

or other potentially infectiousmaterials through contaminatedlinen that was improperly

labeled or handled.


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SUGGESTED SOLUTIONS TO A3OIDOCCUPATIONAL E4POSURES 1Y

O.S.H.A.

andle contaminated laundry as little aspossible with minimal agitation.

0ag contaminated laundry at the locationof use. "o not sort or rinse laundry at thelocation where it was used.

Place wet contaminated laundry in leak-

proof! and color-coded or labeledcontainers! at the location where it wasused.


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O.S.H.A.

Ahenever contaminated laundry is wet andpresents a reasonable likelihood of soak-through or of leakage from the bag or

container! the laundry shall be placed andtransported in bags or containers whichprevent soak-through andBor leakage of Cuidsto the eterior.

Dontaminated laundry must be placed andtransported in bags or containers labeledwith the biohaEard symbol or put in red bags.


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O.S.H.A.

In a facility that utiliEes universalprecautions in the handling of all soiledlaundry alternative labeling or color-

coding is suFcient if it permits allemployees to recogniEe the containers asreGuiring compliance with standardprecautions.

Hse red bags or bags marked with thebiohaEard symbol! if the facility whereitems are laundered does not use +P forall laundry.


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O.S.H.A.

Dontaminated laundry bags shouldnot be held close to the body or

sGueeEed when transporting toavoid punctures from improperlydiscarded syringes.

$ormal laundry cycles should beused according to the washer anddetergent manufacturer5s

recommendations.


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S'andard Pre(au'i"n SP/ f"rhand#in* ("n'a)ina'ed #inens

"onning !ers"na# !r"'e('i-ee5ui!)en' PPE/including

gloves and gowns that provideadeGuate barrier properties.

andwashing facilities! including ahygienic sink! soap dispensers andpaper towels! must be provided inthe soiled-linen processing facility.


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CDC ("n'r"# )easures f"r!r"!er #aundr hand#in*

+oiled linen can betransported in the hospital by

cart or chute. 0agging linen isindicated if chutes are used!since improperly designed

chutes can be a means ofspreading microorganismsthroughout the hospital.


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+oiled linen may or may not besorted in the laundry before being

loaded into washerBetractor units. +orting before washing protects both

machinery and linen from the e#ectsof objects in the linen and reducesthe potential for recontamination ofclean linen that sorting after washingreGuires.


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+orting after washing minimiEes thedirect eposure of laundry personnel

to infective material in the soiledlinen and reduces airborne microbialcontamination in the laundry.

Protective apparel and appropriateventilation can minimiEe theseeposures.


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Phsi(a# and (he)i(a# fa('"rs'ha' a6e('s 'he )i(r"&i(ida#

a('i"n "f 'he n"r)a# #aunderin*!r"(ess

Di#u'i"nis not a microbicidalmechanism but it is responsible forthe removal of signicant Guantitiesof microorganisms.

S"a!s "r de'er*en'sloosen soiland also have some microbicidalproperties


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H"' a'er ashin*of at least 82D (2J? K) in temperature for aminimum of 4: minutes is commonlyrecommended to provide an

e#ective means of destroyingmicroorganisms


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Ch#"rine ea(hprovides an etramargin of safety. % total availablechlorine residual (lowest levelremaining in water after initial

appplication) of ?.??:?< -?.?2:?. S"i#ed #inens

a. %ll linens shall be handled with appropriate barriers

b. Dontaminated linens do not need to be labeled or

placed in red haEard bags regardless of theorganism isolated.

c. %ll soiled linen being placed in chutes must bebagged in such a manner to prevent spillage and

implosion.d. %ll linens should be bagged at the location site and

placed in the appropriate hamper for transportationto laundry.


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Infe('i"n C"n'r"# Pra('i(esFr") Infe('i"n C"n'r"# Manua# f"r Laundr and Linen Ser-i(e& Ra)"nd O'er" Ph.D/

>. S"i#ed #inens &oose soiled linens shall not be

placed on Coors or chairs. +oiled linens with known infectious

organisms do not need to bewashed separately or processed

di#erently.


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>. S"i#ed #inens If low temperature water is to be used to

process soiled linens! make certain that

manufacturerLs recommendations arefollowed.

6emperatures of 2? degrees K should

ideally be used to process linens.

rganisms generally isolated from healthcare facilities cannot survivetemperatures of 2? degrees K along

with the detergents! sours! rinsing or

drying


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>. S"i#ed #inens Processed linens are biologically

safe. +oaps! bleach! sours and etc. should

be used according to manufacturerLsrecommendations.

ampers or carts which are used totransport soiled linens should bedisinfected with MP% registered

chemical prior to reuse.


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>. S"i#ed #inens +oiled linens should be sorted in

separate rooms with an air echange. %irCow will always go from clean to

soiled. It has been recommendedthat 2? air echanges per hour shallbe achieved.

6here shall be a schedule of cleaningof all areas in laundry


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>. S"i#ed #inens

&int contamination shall be containedto a minimum.

6he uses of bacteriostatic softenershave never proven to be e#ective inreducing infections or prolonging the

life of tetiles. % needle bo for disposing sharps

shall be placed in the soiled roomarea. It shall be visible at all times


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?. Chu'es

Dlean as needed or on a regularschedule with an MP% registered

disinfectant.

+hould be under negative pressure.

%ll linens shall be bagged prior to

placing in chutes. "oors shall be kept closed at all times!

have tight gaskets! and should not belocated in halls.L


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9. H"use+ee!in*

&aundry Coors should have a regularcleaning schedule using an MP% registered

disinfectant. &aundry work areas should be cleaned on

a regular schedule using an MP% registereddisinfectant.

%reas should be vacuumed to remove lint.

Aet-vacuumed pickups should be used forterminal cleaning


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@. i))unia'i"n

epatitis 0 vaccine shall be o#ered toall employees in laundry.

%ll laundry personnel shall beencouraged to take it.

6etanus immuniEation shall be kept up-

to-date. InCuenEa vaccination should be

encouraged by the health care facility.


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CONCLUSION

%lthough clean linens instillscondence in the patients and

enhances their faith in the servicesrendered by the hospital! infectioncontrol practitioners must be awarethat the handling of healthcare facility

laundry and linen poses risks toanother population of hospital worker.


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CONCLUSION

Linen and Laundr !ers"nne# should beeGuipped with the +n"#ed*e "n !r"!erhand#in*, s"r'in*, ashin* and

s'"rin* "f (#ean and s"i#ed #inens. A#s", they should be protected from work-

related diseases through the use !r"!er

&arriers su(h as reusae ru&&er/*#"-es and a!r"ns "r *"nsandi))unia'i"ns provided by theinstitution.


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Than+ "u f"r

#is'enin*.

Infection Control on Linen and Laundry Management

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