A Vital Service

By Rock Jensen

December 23, 2014 | Formats: Article | Content Areas: Textile Management Operations | Tags: Environmental hygiene and sanitation, Laundry and Textiles


Laundry processing of health care linens has experienced a significant shift. From the management of self-operated onsite laundry operations to the use of outsourced external central laundries, hospitals are evaluating the cost efficiencies of both in-house and outsourced processes. To do this, they must weigh the value of each while keeping the balance of effective textile care processing as the key fulcrum point in making their decision.

No matter the laundry process chosen, providing clean, sanitary, and comfortable linen is the definitive goal. Hospital laundry products literally touch each patient and most staff in every health care facility. Because of this, standards have been developed to ensure the linen products provided meet the highest criterion for infection prevention, safety, and comfort.

When considering an in-house or outsourced process, it is essential to ensure either practice can implement and sustain these standards as a regular aspect of their daily operations.

How to Choose the Best Textile

A significant consideration in textile care processing is the choosing or acquisition of the most effective textile products for use in your health care facility. Linen products are graded according to their useful life capacity and comfort level. In high-use laundry operations, the higher cotton content items maintain an elevated comfort level, but have a low useful lifespan. To offset this, polyesters are combined into the textile items to add strength to the product and extend its life duration. A 100-percent cotton item will last half as long as a linen item with 50 percent polyester fiber weaved into it.

A “T” reference in hospital linen refers to the thread count of a particular item. The number refers to the number of threads per square inch. Thus a sheet labeled “T180” is a sheet with 180 threads per square inch. A T180 is quite standard in the health care industry.

Textile Care Processing

Next to choosing correct textile products, providing a clean working environment is essential to ensuring a safe laundry product is provided to patients. A daily cleaning schedule must be implemented and adhered to in all laundry areas to ensure a clean, lint- and dust-free setting.

Sorting: All soiled linen returned to the laundry plant is considered contaminated, and use of standard precautions is required in the handling of these items. The laundry must have a functional separation of areas that receive and process soiled linen from areas that process, handle, and store clean linen. This can be accomplished through the presence of either a physical barrier such as a wall (with negative air flow to the outside) or a functional barrier, which uses negative air pressure in the soiled processing area and positive air pressure in the clean processing areas.

The laundry is sorted according to type of fabric, soil type, or type of products (i.e., diapers, sheets, towels). Individuals engaged in soil sorting of linen should use a covering for their clothes while working, and remove the covering before leaving the soiled area and going to any other location in the laundry plant.

Washing: Washing of patient use items should not be combined with linen items used for environmental cleaning and disinfection. Each classification of linen items should have its own wash process standard that consists of: cycle time, water level, water temperature, and chemical usage. These four elements should be programmed and maintained in accordance with local, state, and other regulatory requirements for the wash cycle.

At the end of the wash process, water should be significantly extracted from the textiles, and then the products quickly moved to the drying process so they do not sit in a damp or moist condition.

Drying: Drying times and temperature are determined by textile classification and programmed accordingly. High temperature or extended drying times are the single most destructive process a textile item can undergo, and thus should be kept to the minimum required to dry the items. There should also be a cool-down period where the temperatures are reduced so that laundry staff can handle the linen as it is unloaded from the drying process.

Finishing: Ironers and folders should be operated at the lowest temperature and pressure required to process the category of linen product so as to reduce the destruction of the textile items prematurely.

Storage: The storage of cleaned and processed linen should be in a hygienically sanitary location, protected from potential contamination within or outside of the laundry. Only staff who are wearing clean uniforms and practice hand hygiene should handle clean linen items.

Distribution: The distribution and delivery of clean linen to patient locations must be done in a manner that will minimize contamination from airborne or surface contact.

Clean linen should only be transported in containers or carts that are used for clean linen delivery, and must be regularly sanitized with a disinfectant cleaner. Each cart or container must be covered with a physical barrier. If the cart has an open bottom shelf, it must be lined with a barrier that prevents external contamination from getting on the clean linen items. All cart covers and liners must be cleaned regularly with a disinfectant cleaner. Clean linen must never be transported in the same vehicle as soiled linen. If soiled linen is used in the same vehicle, the interior transport holding area of the vehicle must be cleaned with a disinfectant product.

If a laundry employee is known to be ill with a contact or airborne illness, they should not be engaged in any clean linen process where they could potentially contaminate clean linen products.

Processing and handling of linen products used in a health care setting is a vital service provided, as well as an important link in the infection prevention chain. Understanding these key processes not only allow for a patients comfort but a safe environment to heal.