MARSHALLTOWN MEDICAL AND SURGICAL CENTER LAUNDRY/LINEN SERVICES SUBJECT: Infection Control POLICY NO: 106 PURPOSE: The activities of collecting, processing and delivering an adequate supply of clean linens is the responsibility of the laundry/linen department. These operations include a variety of equipment and techniques that must regularly supply the finished product at a given time to every section of the hospital. The ultimate goal is to perform as many of these tasks with the least amount of contamination to personnel and patients. POLICY: I. Collection A. Personal protective equipment required: Cover gown and gloves. B. Impervious bags which are capable of containing soiled material from the bedside to the linen collection site in the utility room and from there to the Laundry Department, without contaminating the atmosphere, are available and must be used. These bags of linen must be handled with gloves. After handling soiled linens, hands or other skin surfaces shall be washed thoroughly. 1. Nursing should place the wet linen, blood soaked linens or linens contaminated with feces in clear plastic bags with biohazard warning labels. The top shall be secured, placed in linen pick up area to be transported to the Laundry. These bags should always be handled while wearing gloves. 2. If this type of linen is found loose with the bagged linen or the plastic bag leaking, the Charge Nurse for that area should be notified. C. Soiled linens are collected at the bedside in over the back of the chair impervious bags, with biohazard warning labels on them by nursing staff. 1. This eliminates excess handling of linen. 2. Reduces aerosolizing of bacteria. 3. Reduces contamination of personnel s clothing. D. The linen bag shall be closed before taking to soiled utility room. 1. The flap with hand holes facilitates closing and must be used. 2. Bags must be handled while wearing gloves. E. Soiled linen collected from outside of main building shall be transported by vehicle or hand carried. These linens are laundered separately. II. Transporting soiled of Linen A. Personal protective equipment required: Cover gown. B. Transporting of soiled linen shall be in soiled linen green or red covered carts with biohazard warning labels on them. Laundry personnel transporting soiled linen to Laundry Department shall wear scrub uniforms and cover gown. C. Infectious Linen: Linens from isolation soiled with blood or body fluids should be placed in a clear plastic bag in the room. The linen should be bagged out in another clear plastic bag by a person outside the patient s room only if first bag is contaminated on the outside. A biohazard label should be placed on the outer bag.
Page Two III. Soiled Linen Sorting A. Personal protective equipment required: Cover gown and gloves Workers sorting soiled linen should take the following precautions. 1. Gloves. 2. Scrub uniforms. 3. Cover up gowns. 4. Face shield is available if needed. B. The wash aisle represents the transition point between the soiled linen holding areas and all clean linen areas. Neither soiled linen carts nor clean linen carts are stored in the vicinity of the wash aisle. C. Soiled linens are brought to the room adjacent to the Laundry and sorted as little as possible and weighed. Sorted linens are placed directly into washer. D. Isolation linens are not sorted, but placed into washers followed by their outer nylon bags. E. When a washer is ready to be loaded, a full soiled linen cart is moved from the soiled linen holding area to the empty washer. F. The soiled linen is loaded into the washer. Once the washer is loaded, the soiled linen cart is immediately moved back into the soiled linen holding area. G. After linen is placed in washer the employee should remove the disposable gloves and discard gloves into the garbage. Hands should be washed before removing cover gown. Remove cover gown, hang it in the designated area and wash hands. H. Hands should always be washed after removing gloves and cover gown, handling soiled linens and before handling clean linen or leaving the Laundry department. I. After a washer load is finished, a clean cart is brought from the clean linen area to the washer. J. The washed linen is unloaded from the washer into the clean cart. Once the washer is unloaded, the clean linen cart is moved immediately back into the clean linen area. F. At the end of shift the cover gowns should be placed in with the dirty linen to be laundered. IV. Physical Facilities A. Separate facilities should be available for Laundry processing. B. The Laundry area is planned, equipped and ventilated so as to prevent the dissemination of contaminants. C. Soiled sorting; space is allowed for separation of soiled from processed linen. V. Equipment A. Washers must be kept clean and in good working order, washers must not be overloaded. B. Dryer: proper maintenance of filters and exhaust ducts are necessary for lint control. C. Flat work ironer: 1. Area must be kept as dust free as possible. 2. Clean weekly to eliminate lint buildup. 3. Adequate ventilation is necessary in all areas and necessary for reducing steam.
Page Three D. Transport Carts: 1. Should be easily cleaned. 2. Carts are cleaned weekly with quaternary disinfectant cleaner. 3. Separate carts are provided for soiled, clean, processed linens. a. Soiled carts are green or red. b. Clean carts are gray, yellow, or metal. E. Laundry Bags: 1. Should be made of a durable impervious material. 2. Capable of being closed effectively. 3. Easily launderable. VI. Factors in Elimination of Bacteria A. High temperatures, 160 degree F. B. Dilution - The many water changes in a wash cycle flush bacteria from the linens down the drains. C. Bleach suds also destroy bacteria with its chlorine content. D. Souring operation assists in destroying surviving bacteria, if the ph is lowered to around 6.0. E. High ironing and dryer temperatures will destroy bacteria. VII. Clean Linen A. Personal Protective Equipment Required: None. B. Should be covered during storage. C. Should be handled as little as possible. D. Shelves, carts, etc., used to store clean linen should be cleaned weekly with a cloth moistened with a quaternary disinfectant cleaner. E. Delivery and Storage: 1. Transporting of clean linen shall be in yellow, gray or metal covered carts. 2. Clean linens are stored on patient care units in a clean, dry area. (Clean utility rooms and linen closets). 2. All linens must be covered. 3. Clean linen transported outside of the main building shall be transported in laundry bags by vehicle. F. Pillows are cleaned with appropriate quaternary disinfectant cleaner between patient use. VIII. Personnel A. Employees are expected to maintain a high degree of personal cleanliness. B. Employees are expected to practice good hand washing before starting to work, before and after breaks, after using the restroom and after removing gloves and cover gowns used for handling soiled linen. C. Persons with boils, infected wounds or acute respiratory infections should not work with clean or processed linen. Notify Supervisor and/or Infection Control person of these conditions.
Page Four D. Uniforms: All Laundry personnel shall wear designated scrub uniforms. E. All personnel who work in the Laundry area will be offered Hepatitis B immunization free of charge. IX. Cleaning of the Laundry Equipment A. At the beginning of each workday, the following areas should be damp cleaned with appropriate quaternary disinfectant cleaner 1. Work table surfaces used for folding and stacking linens. 2. Storage shelves and carts where processed linens are placed until disposition. a. Do not sit on clean work table. b. Do not put shoes on clean surface. B. Weekly: 1. Routine Laundry Department cleaning. a. Vacuum lint from collection points. b. Exterior of washers are wiped with damp cloth. c. Floors are dust mopped and wet mopped by ENS, clean area and then dirty areas and dirty linen bin area. 2. Linen Service - shelves and tables are cleaned by linen service personnel. 3. Clean line and spring bottom carts are cleaned when empty. C. Monthly - More heavy duty cleaning: 1. On top of and behind machines. 2. Cleaning of stainless steel on washer. 3. Greasing of all machines. D. 3 Months 1. Remove lint from ceiling and off pipes and light fixtures. 2. Clean lint from light fixtures. X. Service employees should annually be informed of the necessity of safe handling A. New employees receive orientation practices of clean and soiled linen. Each employee has the responsibility to control the transmission of infection or disease, to himself or to the clean linen which ultimately reaches the patient. B. All employees must be knowledgeable of universal precautions/standard precautions Originated by: Laundry/Linen Dept Effective date: 9/89 Authorized by: Date Revised: 90, 91, 92, 95, 97, 00, 8/04, Date Reviewed: 2/10