infection prevention and control in linen and laundry management - copy

8/16/2019 Infection Prevention and Control in Linen and Laundry Management - Copy

1/46

INFECTION

PREVENTION ANDCONTROL ONLINEN AND LAUNDRY

MANAGEMENT

ROSAFE E. PERALTA, RN, MANChief Nurse

MARYMOUNT HOSPITAL


2/46

INTRODUCTION

Patient-care delivery workeris often the person thought

of rst; when it comes toprotecting hospitalpersonnel from the

transmission of infectiousdiseases


3/46

INTRODUCTION

Infection control

practitioners must be awarethat the handling ofhealthcare facility laundry

and linen poses risks toanother population ofhospital worker.


4/46

INTRODUCTION

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


5/46


6/46

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 %.


7/46

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


8/46

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.


9/46

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 rural 6ennessee county were eamined.


10/46

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 $ie$!

re"resen(e se)#nar! (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.


11/46


Three $aunr! "ers#nne$ -h#ha n# )#n(a)( -i(h resien(s

-ere infe)(e. 'ost of the ill residents (>2


12/46


Launr! "ers#nne$ re+u$ar$! a(e in(he $aunr! r##*, i n#( -ear"r#(e)(ie )$#(hin+ an i n#( -ear

+$#es )#nsis(en($! -hi$e han$in+s#i$e $aunr!.

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.


13/46

The Cen(ers f#r Disease C#n(r#$an Preen(i#n /CDC01sGuie$ines f#r Launr! 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.,


14/46

CONTAMINATEDLAUNDRY

,laundry which has been soiledwith blood or other potentially

infectious material or maycontain sharps. 23$##'#rnePa(h#+en S(anar issued by

the O))u"a(i#na$ Safe(! anHea$(h A*inis(ra(i#n/OSHA04


15/46

CONTAMINATEDLAUNDRY

+% says healthcare facilitylaundry poses eposure to blood

or other potentially infectiousmaterials through contaminatedlinen that was improperly

labeled or handled.


16/46

SUGGESTED SOLUTIONS TO AVOIDOCCUPATIONAL E5POSURES 3Y

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.


17/46


O.S.H.A.

@henever 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 andAor leakage of Buidsto the eterior.

Contaminated laundry must be placed andtransported in bags or containers labeledwith the biohaDard symbol or put in red bags.


18/46


O.S.H.A.

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

coding is suEcient if it permits allemployees to recogniDe the containers asreFuiring compliance with standardprecautions.

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


19/46


O.S.H.A.

Contaminated laundry bags shouldnot be held close to the body or

sFueeDed when transporting toavoid punctures from improperlydiscarded syringes.

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

recommendations.


20/46

S(anar Pre)au(i#n /SP0 f#rhan$in+ )#n(a*ina(e $inens

"onning "ers#na$ "r#(e)(iee6ui"*en( /PPE0 including

gloves and gowns that provideadeFuate barrier properties.

andwashing facilities! including

a hygienic sink! soap dispensersand paper towels! must beprovided in the soiled-linenprocessing facility.


21/46

CDC )#n(r#$ *easures f#r"r#"er $aunr! han$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.


22/46


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

loaded into washerAetractor 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 washingreFuires.


23/46


+orting after washing minimiDes thedirect eposure of laundry personnel

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

Protective apparel and appropriateventilation can minimiDe theseeposures.


24/46

Ph!si)a$ an )he*i)a$ fa)(#rs(ha( a7e)(s (he *i)r#'i)ia$

a)(i#n #f (he n#r*a$ $aunerin+"r#)ess

Di$u(i#n is not a microbicidalmechanism but it is responsible forthe removal of signicant Fuantitiesof microorganisms.

S#a"s #r e(er+en(s loosen soiland also have some microbicidalproperties


25/46



H#( -a(er -ashin+ of at least 82HC (2? HJ) in temperature for aminimum of 4: minutes is commonlyrecommended to provide an

e#ective means of destroyingmicroorganisms


26/46



Ch$#rine '$ea)h provides an etramargin of safety. % total availablechlorine residual (lowest levelremaining in water after initial

appplication) of ?.??:?< -?.?2:?<is usually achieved during the bleach

cycle.


27/46



6he last action performed during thewashing process is the ai(i#n #f a*i$ a)i to neutraliDe any alkalinityin the water supply! soap! or

detergent. 6he rapid shift in Ph fromapproimately 24 to : also may tendto inactivate some microorganisms.


28/46



L#-er -a(er (e*"era(ures #f&&8C9:; 8C when the cycling ofthe washer! the wash formula!and the amount of chlorinebleach are carefully monitoredand controlled shows satisfactory


29/46



the temperatures reached inr!in+ and especially duringir#nin+ "r#ie ai(i#na$si+ni


30/46

IN=URIES FROM SHARPS

Injuries from sharps like needles!raDor blades and surgical

instruments being swept up inpatient-room or surgical linensare the real threats posed by

contaminated linens


31/46

HO> TO AVOID IN=URIESFROM SHARPS

proper linen handling can help eliminatethese kinds of injuries

ealthcare workers must be in-serviced onhow to look for sharps buried in linen andhow to remove and contain them.

% safety and health program that includes

procedures for appropriate disposal andhandling of sharps

Jollow reFuired practices is outlined in the0loodborne Pathogens +tandard.


32/46

Infe)(i#n C#n(r#$ Pra)(i)es/Fr#* Infe)(i#n C#n(r#$ Manua$ f#r Launr! an Linen Seri)e'! Ra!*#n O(er# Ph.D0

%. Pers#nne$a. $ eating! drinking! smoking! application of cosmetics or

chewing gum in the laundry area.

b. %ll laundry personnel will follow standard precautions forhandling of all soiled linens.

c. Proper barriers such as reusable (rubber) gloves andaprons or gowns that prevent soak-through will beprovided and used correctly when handling soiled linens.

d. and washing facilities shall be provided in the soiledroom. 6he area should be eFuipped with a hygienic sink!paper towels! and soap dispensers.

e. +oiled linen handlers will be in-serviced on how to pick upsharps from linens or Boors.


33/46


&. C$ean $inen

a. 6here shall be an adeFuate inventory of clean linenat all times.

b. $ cross contamination shall eist between cleanand soiled linens.

c. Clean linens shall be transported in cover carts ifthey are going to be stored on the cart while on

the Boors.d. Clean linens do not need to be covered on

transportation if they are going to be placed indrawers or cabinets. pen carts should not beused for storage of clean linens on the Boors.


34/46


&. C$ean $inen

a. ands should be washed before handling cleanlinens.

b. Clean linens should not be shaken or placed inareas that may contain environmentalcontamination! i.e. air conditioners! chairs! etc.

c. %ny linen that is repaired needs to be re-

washed.

d. +helves which are used to store clean linensshall be free of dust! vermin! and traEc Bow.


35/46


?. S#i$e $inens

a. %ll linens shall be handled with appropriate barriers

b. Contaminated linens do not need to be labeled or

placed in red haDard 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.


36/46


?. S#i$e $inens &oose soiled linens shall not be

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

organisms do not need to bewashed separately or processed

di#erently.


37/46


?. S#i$e $inens If low temperature water is to be used to

process soiled linens! make certain that

manufacturerKs recommendations arefollowed.

6emperatures of 2? degrees J should

ideally be used to process linens.

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

with the detergents! sours! rinsing or

drying


38/46


?. S#i$e $inens Processed linens are biologically

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

be used according to manufacturerKsrecommendations.

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

chemical prior to reuse.


39/46


?. S#i$e $inens +oiled linens should be sorted in

separate rooms with an air echange. %irBow 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


40/46


?. S#i$e $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


41/46


@. Chu(es

Clean as needed or on a regularschedule with a registered disinfectant.

+hould be under negative pressure.

%ll linens shall be bagged prior toplacing in chutes.

"oors shall be kept closed at all times!have tight gaskets! and should not belocated in halls.K


42/46


:. H#useee"in+

› &aundry Boors should have a regularcleaning schedule using an LP% registered

disinfectant.› &aundry work areas should be cleaned on

a regular schedule using an LP% registereddisinfectant.

› %reas should be vacuumed to remove lint.

› @et-vacuumed pickups should be used forterminal cleaning


43/46


. I**uniBa(i#n

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

› %ll laundry personnel shall beencouraged to take it.

› 6etanus immuniDation shall be kept up-

to-date.› InBuenDa vaccination should be

encouraged by the health care facility.


44/46

CONCLUSION

%lthough clean linens instillscondence in the patients and

enhances their faith in the servicesrendered by the hospital! infectioncontrol practitioners must be awarethat the han$in+ #f hea$(h)are

fa)i$i(! $aunr! an $inen "#sesriss (# an#(her "#"u$a(i#n #fh#s"i(a$ -#rer.


45/46

CONCLUSION

Linen an Launr! "ers#nne$ should beeFuipped with the n#-$e+e #n "r#"erhan$in+, s#r(in+, -ashin+ an

s(#rin+ #f )$ean an s#i$e $inens. A$s#, they should be protected from work-

related diseases through the use #f

"r#"er 'arriers su)h as reusa'$e/ru''er0 +$#es an a"r#ns #r +#-ns and i**uniBa(i#ns provided by theinstitution.


46/46

Than !#u f#r

$is(enin+.

infection prevention and control in linen and laundry management - copy

Documents