Hang infections out to dry

Laundry infection control is paramount in health and care applications, where specific Department of Health guidance is in place to prevent the possibility of cross contamination. It is also true that all on-premise laundries will do well to adhere to the guidance and best practice recommendations, especially where the risks associated with cross contamination could be high, such as food and drink preparation, hotels, schools, and animal care.

Even in domestic environments the washing machine can become the vector for passing on infections, especially as many households now wash at lower temperatures and without adequate chemical disinfection. Sometimes the risk only comes to light after sickness has passed around the household! Professional on-premise laundries cannot take these risks and need to be mindful of best practice, even if they are not in the highest risk areas, such as care homes regularly processing foul laundry.

Guidance for healthcare applications

The most recent guidance for on-premise laundries in healthcare applications is contained in the Department of Health’s document CfPP 01-04. Care and nursing homes need to adhere to the guidance to meet Care Quality Commission (CQC) standards for laundry design and operation.

Specific hygiene measures should be taken to reduce the risks of cross-contamination between infected and clean linen. These include correct handling to prevent the spread of infection and effective decontamination of linen.

Guidance also states that when washing machines are due to be replaced to look for energy efficient models. Healthcare establishments must keep a logbook of any service and repair visits and have written policies and safe working procedures for the operation of all washing machines and dryers. Appropriate PPE must be available for all staff.

The latest guidance requires use of a commercial washing machine capable of meeting disinfection requirements. A hot wash cycle is recommended (71ºC for at least three minutes or 65ºC for at least ten minutes) or alternatively a chemical disinfection process. The washing machine’s disinfection stage must be validated at least annually.

Some of the latest, computer-controlled high-speed washer extractors have a greater range of programmes to ensure that they can deal effectively with any fabric. Drying is equally important. The latest tumble dryers are designed to deliver energy efficiency, high productivity, quick drying and low maintenance.

By design

The laundry area should be designed to minimise the risk of recontamination of linen. This should include segregation of clean and dirty items and areas within the laundry room and hand decontamination facilities.

Care needs to be paid to laundry layout to ensure proper provision of clean and dirty areas. This includes separate access with dirty laundry and egress with clean laundry. A separate storage area is also required for clean laundry.

It can also be helpful to have a clearly displayed list of Dos and Don’ts in the laundry as a reminder to all of everyday best practice for good hygiene, effective laundry management and machine care:

Do

• Clean the washer soap dispenser regularly

• Wear protective gloves and apron when handling dirty laundry

• Keep soiled laundry separate from the clean area

• Clean the dryer lint filter every day

• Ensure correct wash and dry programmes are selected

• Keep machines clean

• Wash hands regularly especially when entering and leaving the laundry room

• Always observe COSHH regulations

Don’t

• Sort laundry on the floor

• Ever open red bags of foul/infected laundry

• Mix trollies with clean and dirty linen

• Under load or overload the equipment

• Stack items on top of or against the machines

• Eat food in the laundry