This articles author is Raymond Otero Ph.

Infection Control Manual for Laundry and Linen Service

A. Introduction
Clean linen delivered in a timely manner to health care areas is important. Many different areas exist in a hospital or a longterm care facility that require processed linens as well as removal of contaminated linens. Infection control manuals should be
written with the intent of discouraging the creation of anxiety and over processing of linens. If one follows common sense
procedures (Standard Precautions) in handling grossly contaminated linens, the chance of disease transmission is almost
nonexistent. There has not been any documentation that processed (clean) linens in a hospital has caused infections in the
United States. There have been a few documented cases that contaminated linens were the cause of infections among
handlers, i.e., scabies, salmonella, small pox. All cases so described demonstrated a break in technique. However, if one
considers the poundage of linen processed in hospitals in this country, the number of infections are very minimal, almost
nonexistent. One does have to be very careful of sharps in linen hampers such as needles, razor blades, surgical instruments,
broken glass and etc. If the linen handler is taught how to remove linens from hampers correctly, injuries will be avoided.
B. Responsibilities of:
1. Laundry Manager
a. Responsible for all operations in the laundry.
b. Reviews equipment and procedures including maintenance.
c. Assures adequate inventories.
d. Evaluates all products used in the laundry.
e. Develops infection control policies for laundry and personnel practices.
f. Develops in-service educational programs for staff.
2. Surveillance Officer
a. Reviews all policies that regard infection control practices.
b. Assists in educational programs with the laundry manager.
c. Consults with the laundry manager when necessary.
3. Infection Control Committee
a. Reviews all procedures developed by the laundry manager.
4. Epidemiologist (Chairperson of the Infection Control/Quality Review committee)
a. Acts as a consultant whenever necessary with the above personnel.
C. Infection Control Practices
1. Personnel
a. NO eating, drinking, smoking, application of cosmetics or chewing gum in the laundry area.
b. All laundry personnel will follow standard precautions for handling of all soiled linens .
c. Proper barriers such as reusable (rubber) gloves and aprons or gowns that prevent soak-through will
be provided and used correctly when handling soiled linens.
d. Hand washing facilities shall be provided in the soiled room. The area should be equipped with a
hygienic sink, paper towels, and soap dispensers.
e. Soiled linen handlers will be in-serviced on how to pick up sharps from linens or floors.

2. Clean linen
a. There shall be an adequate inventory of clean linen at all times.
b. NO cross contamination shall exist between clean and soiled linens.
c. Clean linens shall be transported in cover carts if they are going to be stored on the cart while on the
floors.
d. Clean linens do not need to be covered on transportation if they are going to be placed in drawers or cabinets. Open
carts should not be used for storage of clean linens on the floors.
e. Hands should be washed before handling clean linens.
f. Clean linens should not be shaken or placed in areas that may contain environmental contamination, i.e. air conditioners,
chairs, etc.
g. Any linen that is repaired needs to be re-washed.
h. Shelves which are used to store clean linens shall be free of dust, vermin, and traffic flow.

1. Soiled linens
a. All linens shall be handled with appropriate barriers (see infection control above).
b. Contaminated linens do not need to be labeled or placed in red hazard bags regardless of the organism
isolated.
c. All soiled linen being placed in chutes must be bagged in such a manner to prevent spillage and implosion.
d. All linens should be bagged at the location site and placed in the appropriate hamper for transportation to laundry.
e. Loose soiled linens shall not be placed on floors or chairs.
f. Soiled linens with known infectious organisms do not need to be washed separately or processed differently.
g. If low temperature water is to be used to process soiled linens, make certain that manufacturers recommendations are
followed.
h. Temperatures of 140 degrees F should ideally be used to process linens. However, states may have their own regulations on
what temperatures to use. Organisms generally isolated from health care facilities cannot survive temperatures of 140 degrees
F along with the detergents, sours, rinsing or drying.
Processed linens are biologically safe.
i. Soaps, bleach, sours and etc. should be used according to manufacturers recommendations .
j. Hampers or carts which are used to transport soiled linens should be disinfected with EPA registered chemical prior to
reuse.
k. Water soluble bags (those that melt in hot temperatures) used for transportation of soiled lines are unnecessary and
costly.
I. Soiled linens should be sorted in separate rooms with an air exchange.
m. Airflow will always go from clean to soiled. It has been recommended that 10 air exchanges per hour shall be achieved.
n. There shall be a schedule of cleaning of all areas in laundry
0. Lint contamination shall be contained to a minimum.
p. The use of bacteriostatic softeners have never proven to be effective in reducing infections or prolonging the life of
textiles.
q. A needle box for disposing sharps shall be placed in the soiled room area. It shall be visible at all times.

2. Chutes
a. Clean as needed or on a regular schedule with an EP A registered disinfectant.
b. Should be under negative pressure.
c. All linens shall be bagged prior to placing in chutes.
d. Doors shall be kept closed at all times, have tight gaskets, and should not be located in halls.

5. Environmental cultures
a. Environmental cultures shall not be performed on linens for any reason. There are no standards that
have been developed for any interpretation.
D: Visitors
1. Casual visitors should not be allowed in the laundry area.

E. Engineering
1. A preventive maintenance program shall be developed by the health care facility.
1. There shall be a contingency plan written by the health care facility indicating an alternative provision that may be
followed provision that may be followed requirements necessary for normal activity.

F.

Housekeeping
1. Laundry floors should have a regular cleaning schedule using an EPA registered disinfectant.
1. Laundry work areas should be cleaned on a regular schedule using an EPA registered disinfectant.
3. Areas should be vacuumed to remove lint.
4. Wet-vacuumed pickups should be used for terminal cleaning.

G. Controls of the system

1. Temperature of wash cycles shall be recorded.
2. Policies and procedure manuals should be examined at times specified by the licensure agency or infection control
committee.
H. Immunizations
1. Hepatitis B vaccine shall be offered to all employees in laundry.
2. All laundry personnel shall be encouraged to take it.
3. Tetanus immunization shall be kept up-to-date.
4. Influenza vaccination should be encouraged by the health care facility.

I.

Employee health
1. Work restriction guidelines shall be written for the laundry area.
J. Summation
1. Linens shall not be shaken excessively to create aerosols.
2. Avoid unnecessary handling of clean linens.
3. Wash hands when indicated.
4. Wear appropriate barriers when handling soiled linens.
1. Try to reduce unnecessary costs in the laundry area. Sometimes we use procedures that have never been proven to be
effective, i.e., water-soluble bags, bacteriostatic softeners, etc.