AMR/IPC Unit
WHO - EMRO
2022
3- Laundry Services
Learning objectives
• Understand standards for transporting, receiving, processing, storing and
distributing linen.
• Learn about management of specific textile in healthcare settings
General Aspects of Laundry
• Contaminated textiles and fabrics often contain high numbers of microorganisms from body
substances, including blood, skin, stool, urine, vomitus, and other body tissues and fluids.
• When textiles are heavily contaminated with potentially infective body substances, they can contain
bacterial loads of 106 –108 CFU/100 cm2 of fabric.
• Disease transmission attributed to health-care laundry has involved contaminated fabrics that were
handled inappropriately (i.e., the shaking of soiled linens). Bacteria (Salmonella spp., Bacillus
cereus), viruses (hepatitis B virus [HBV]), fungi (Microsporum canis), and ectoparasites (scabies)
presumably have been transmitted from contaminated textiles and fabrics to workers via:
• direct contact or
• aerosols of contaminated lint generated from sorting and handling contaminated textiles
• Hygienically clean laundry carries negligible risk to health-care workers and patients, provided that
the clean textiles, fabric, and clothing are not inadvertently contaminated before use.
https://www.cdc.gov/infectioncontrol/guidelines/environmental/background/laundry.html
LAUNDRY CARE
• Hospital linen are divided into the following four
categories at source:
• Clean linen that are washed and ready to use.
• Used linen—that has not been contaminated or
exposed to body or body fluids, infectious patients, or
their environment.
• Infectious linen—used by a person known or
suspected to be infectious and linen that is
contaminated with either blood or body fluids.
Management of hospital linen and laundry:
• Personnel who handle hospital linen must adhere to infection
prevention and control practices during collection, transportation,
laundering, packaging and storage, and delivery of clean linen.
• 1. Collection of soiled linen:
• Soiled linen must be bagged at the point of generation in a
way that minimize microbial contamination of the air and the
personnel handling the textiles.
• Place linen that are heavily soiled linen with body fluids in a
water-soluble bag when available.
• The bags or other containers must be color-coded or labeled.
• Laundry bags should not be filled more than 75% full.
• 2. Interim storage of soiled linen:
• Store soiled linen in a secure area with no direct public
access. This area can be the dirty utility in each hospital ward.
• Clean storage area and all containers on a daily basis.
Management of hospital linen and laundry:
• 3. Laundering process
• The laundering process is designed to remove organic soil and render the
linen clean. Laundering cycles consist of flush, main wash, bleaching, rinsing,
and souring.
• 4. Packaging and Storage:
• Maintain the linens in a clean state for delivery to the customer.
• 5. Delivery of Clean linen:
• Clean linen must be covered during transport and storage to prevent
contamination; transportation carts should be routinely cleaned/disinfected.
Best Practices for linen management in
Healthcare Facilities
• Best practices for personal protective equipment (PPE) for laundry
staff:
• Practice hand hygiene before application and after removal of PPE.
• Wear tear-resistant reusable rubber gloves when handling and laundering
soiled linens.
• If there is risk of splashing, for example, if laundry is washed by hand, laundry
staff should always wear gowns or aprons and face protection (e.g., face
shield, goggles) when laundering soiled linens.
Best Practices for linen management in
Healthcare Facilities
• Never carry soiled linen against the body. Always place it in the designated container.
• Carefully roll up soiled linen to prevent contamination of the air, surfaces, and cleaning staff. Do
not shake linen.
• If there is any solid excrement on the linen, such as feces or vomit, scrape it off carefully with a
flat, firm object and put it in the commode or designated toilet/latrine before putting linen in the
designated container.
• Place soiled linen into a clearly labelled, leak-proof container (e.g., bag, bucket) in the patient
care area. Do not transport soiled linen by hand outside the specific patient care area from where
it was removed.
• If reusable linen bags are used inside the designated container, do not overfill them, tie them
securely, and launder after each use. Soiled linen bags can be laundered with the soiled linen they
contained.
Best Practices for linen management in
Healthcare Facilities
• The effectiveness of the laundering process depends on many factors,
including:
• time and temperature
• mechanical action
• water quality (pH, hardness)
• volume of the load
• extent of soiling
• model/availability of commercial washers and dryers
Best Practices for linen management in
Healthcare Facilities
• Always use and maintain laundry equipment according to manufacturer’s
instructions.
• Always launder soiled linens from patient care areas in a designated area,
which should:
• be a dedicated space for performing laundering of soiled linen
• not contain any food, beverage or personal items
• have floors and walls made of durable materials that can withstand the exposures
of the area (e.g., large quantities of water and steam)
• have a separation between the soiled linen and clean linen storage areas, and
ideally should be at negative pressure relative to other areas
• have handwashing facilities
• have SOPs and other job aids to assist laundry staff with procedures
Best Practices for linen management in
Healthcare Facilities: in Resource-Limited
Settings
• Best practices for laundering soiled linen:
• Follow instructions from the washer/dryer manufacturer.
• Use hot water (70–80°C X 10 min) [158–176°F]) and an approved laundry
detergent.
• Disinfectant are generally not needed when soiling is at low levels.
• Use disinfectant on a case by case basis, depending on the origin of the soiled linen (e.g.,
linens from an area on contact precautions).
• Dry linens completely in a commercial dryer.
If laundry services with hot water are not
available, reprocess soiled linens manually
according to the following
https://www.cdc.gov/hai/pdfs/resource-limited/environmental-cleaning-RLS-H.pdf
Best Practices for linen management in
Healthcare Facilities: in Resource-Limited
Settings
• Best practices for management of clean linen:
• Sort, package, transport, and store clean linens in a manner that prevents risk
of contamination by dust, debris, soiled linens or other soiled items.
• Each floor/ward should have a designated room for sorting and storing clean
linens.
• Transport clean linens to patient care areas on designated carts or within
designated containers that are regularly (e.g., at least once daily) cleaned
with a neutral detergent and warm water solution.
Infection Control Basics for Healthcare Hideo
Laundry Services
https://www.youtube.com/watch?v=zRtQ4zndmLw&ab_chann
el=OregonPatientSafetyCommission
Textiles
PRIVACY CURTAINS
• curtains should be changed and cleaned on a
routine schedule and when visibly soiled
• Newer-designed curtains have been impregnated
with an antimicrobial coating consisting of one of
the following:
• silver-based compounds,
• silane quats,
• triclosan, or
• zinc pyrithione.
• When evaluating antimicrobial curtains, the
facility should verify that the textile has an EPA
registration
MATTRESSES AND PILLOWS
• moisture-resistant material and are easy to clean
• Fabric covers are not recommended.
• laundered between patients
• Mattresses and pillows must be cleaned and
disinfected with an EPA-registered disinfectant
and according to manufacturer's
recommendations between each patient and
when visibly soiled
References
• APIC Text 2021: chapters 107, 111, 114, 115, 116 https://apic.org/resources/apic-text/
• APIC - Environment of Care
https://apic.org/resources/topic-specific-infection-prevention/environment-of-care/
• CDC: Laundry and bedding
https://www.cdc.gov/infectioncontrol/guidelines/environmental/background/laundry.html
• Oregon Patient Safety Commission - Infection Control Basics for Healthcare Laundry Services:
https://www.youtube.com/watch?v=zRtQ4zndmLw&ab_channel=OregonPatientSafetyCommissio
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