- Created on Tuesday, 03 April 2001 01:45
- Written by Raymond B. Otero
State and Federal laws do not require that personnel who handle contaminated textiles be certified in order to achieve accreditation. However, it has been NAILM’s opinion for the past 24 years that in order for personnel to work in either laundry or environmental services that proper training is important to reduce excessive cost and injuries.
These abbreviated guidelines, excerpted from NAILM’s recently published Healthcare Textile Infection Control Guidelines, will allow the provider of laundry and environmental services to achieve a better understanding of
infection control practices.
If one follows STANDARD PRECAUTIONS (formerly known as Universal Precautions/Body Substance Isolation) in handling all contaminated linens, the chance of disease transmission will be almost non-existent. A break in safety techniques can be the cause of healthcare workers getting infected through the handling of soiled linens.
Collection and Transportation of Soiled Textiles
Soiled linen should be handled as little as possible and with a minimum of agitation to prevent gross microbial contamination of the air and persons handling the linen. All linens regardless of origin should be handled in the same manner (Standard Precautions). All soiled linen should be bagged at the location where it was used.
The collection bag should be of sufficient quality to contain the wet/soiled linens and prevent soak-through (leakage) during handling and transportation. The type of bag that will be used is dependent on the amount of soil generated by the patient. Cloth laundry bags today are of sufficient quality to prevent soak-through with normal handling or being transported in chutes. Plastic bags are commonly used for the transportation of soiled linens in healthcare.
The use of personal protective equipment such as reusable gloves and gowns or aprons should be made available to all personnel who are handling soiled linens. The use of masks is not required since aerosols generated by inappropriate handling of linens will not cause respiratory illness. The particles generated are so large that they will not enter lung tissues (see www.cinetwork.com/otero and click on prevention of diseases).
Reusable gloves should be used rather than disposable because of the thinness of the latter, which do not protect the health care worker from gross contamination or tearing. Latex or vinyl gloves were never intended to receive the physical pressure that sorting of linens creates. It is not unusual for a laundry worker in the soiled area to use a box of latex gloves per day for protection. Every time gloves are torn or removed, handwashing must be performed.
The use of protective eyewear is not necessary because the splashing of blood or body fluids from linens is unlikely. The use of hairnets or foot covers is not necessary and it is up to the discretion of the laundry manager if they are required. For infection control purposes, these items are not necessary.
Handwashing sinks are required in the soiled room area. It would be inappropriate that soiled–linen handlers have to go outside of their area to wash their hands. The sink should be only used for handwashing, it should be clean and contain a soap dispenser, and paper towels. The use of antiseptic soaps in the soiled linen area is controversial. The most important factor is good handwashing. The use of a good lotion soap is more than satisfactory. It is not what you wash your hands with – it is how and when you wash your hands that is important.
The finding of sharps or other items in textiles received in the soiled room area is not unusual. Soiled textiles coming to the dirty-room sorting area should be examined carefully. This will prevent occupational exposures and infections from bloodborne pathogens or other organisms. It is also important that soiled-linen personnel become trained on how to pick up needles and other sharps that may have inadvertently hit the floor (dust pan or forceps only). Remember it is OSHA’s rule that needle boxes must be placed in areas where linens are sorted. It must be clearly visible to anyone entering this area.
The laundry facilities shall be designed, equipped, and ventilated to reduce the dissemination of microorganisms onto finished textiles. The ventilation shall include adequate intake, filtration, air exchange rate (5 – 10 per hour) and exhaust in accordance with local, state and federal regulations. The soiled linen area shall be separated physically from the clean linen area.
Linen contaminated with hazardous drugs or excreta from patients who have received hazardous drugs in the past 48 hours is a potential source of exposures to employees. Linen soiled with blood or other potentially infectious materials as well as contaminated with excreta must also be managed according to the infection control manual of the facility (Universal Precautions). Linen that is grossly contaminated with hazardous drugs such as a spillage should be placed in a chemotherapy waste disposal unit. Linens used by patients who have received hazardous drugs, which are not grossly contaminated, shall be handled as other linen.
It is important that providers understand infection control practices for handling, processing, storage and delivery of textiles in a healthcare setting. Too often stringent, non-sensible recommendations are made without foundation. It is hoped that these guidelines will help in alleviating some of these misconceptions.
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