Laundry and Linen Management

practices
 Standard 2i
The organization adheres to
laundry and linen management
processes

Prevention of Hospital acquired Infections, 2nd edition, G, Ducel et al, World health organization ,2002, WHO/CDS/CSR/2002.12,
 Laundry and Linen management
Laundry
• Laundry in a healthcare facility generally include bed sheets, blankets, towels,
personal clothing, patients apparel,uniforms,scrub suite, gowns and drapes for
surgical procedure
• Regardless of the use of ‘in house’ or ‘off site contract' services appropriate
procedures are required to minimize the risk associated with handling soiled
textiles
• Basic hygienic approaches for handling,processing,and storage of textiles are
sufficient to reduce the risk of cross-infection
• A laundry area should be specifically designated in health set-ups if the laundry
services are not being outsourced
• The laundry must not be situated near the food preparation area. It should have
impermeable floor surfaces. It should be designed, equipped and ventilated to
reduce the dissemination of micro organism on to the finished textiles. The
ventilation should include adequate filtration, air exchange rate (5-10/h) and
exhaust

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CDC - Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008
 Laundry and Linen management
Laundry
• The laundry is usually partitioned into two separate areas: a ‘dirty area’ for
receiving and handling the soiled laundry and a ‘clean area' for processing the
worked items and textile storage. Functional separation may be achieved by
physical barriers, negative air pressure systems in the soiled linen area or
positive airflow from the clean area to the soiled linen area
• The laundry areas must have adequate handwashing facility
• The laundry equipment must be used and maintained according to the
manufactures instructions
• Damp textiles should not be left in the machine overnight
• If the hospital laundering is outsourced similar policies should be implemented
and members of the ICT should make frequent visits to monitor the laundry
process regularly

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CDC - Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008
 Laundry and Linen management
Collection, sorting and transportation of soiled linens
• Soiled linen should be handled as little as possible and with minimum agitation
to prevent gross microbial contamination of the air and of persons handling the
linen.
• All soiled linen should be bagged or placed in containers at the location where it
was used and should not be sorted or rinsed in the location of use.
• Linen contaminated with blood or other body fluids should be bagged and
transported in a manner that will prevent leakage. Bags should not be overly
filled and they should be labelled for easy identification
• Contaminated laundry should be transported by cart or chute. Clean and soiled
textiles should be transported separately to ensure minimal microbial
contamination. HCO can have color coding for linen collecting bags
• Soiled linen is generally sorted in the laundry before washing. Gloves and other
appropriate protective apparel should be worn by laundry personnel while sorting
soiled linen. All laundry workers should be properly immunized

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CDC - Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008
 Laundry and Linen management
Washing of textiles
• Healthcare workers should note the cleaning instructions of textiles, fabrics,
drapes and clothing to identify special laundering requirements. The basic
laundering cycles consist of flush, main wash, bleaching, rinsing and souring
• Following are the wash cycles currently used for washing linen:
- Hot Water Washing: Linen are washed with a detergent in water at 710C
(1600F) for 25 minutes. Water of this temperature can be provided by steam
jet or separate booster heaters
- Low Temperature Water Washing: Linens are washed at lower water
temperature (71.6-1220F;22-500C). Instead of microbial action of hot water,
low temperature laundry cycles rely heavily on the presence of chlorie-or
oxygen activated bleach to reduce level of microbial contamination. This cycle
is also ideal for heat labile linen

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CDC - Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008
 Laundry and Linen management
Washing of textiles
- Disinfection: A chlorine releasing agent to give a final concentration of 150
parts per million (ppm) available chlorine can be introduced in the bleach
cycles. Chlorine compound should not be used on fabrics treated for fire
retardance. Hydrogen peroxide may be used for disinfection in such cases.
Rinse again to wash off chlorine
- Drying: The temperature during drying cycles of washers and ironing provides
an additional antimicrobial activity. The linen should be dried preferably in a
dryer or sun (heavy duty washer/dryer are recommended)
Storage and Transportation of cleaned linens
• There should be a separate area for drying, ironing and storage of clean linen,
away from used linen to prevent contamination
• Clean linen should be stored in a dry area above the floor level

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CDC - Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008
 Laundry and Linen management
Storage and Transportation of cleaned linens
• Clean linen should not be stored in bathrooms
• Staff with unhealed lesions ,rashes or exfoliate
skin conditions should not handle clean laundry
unless the lesions are covered with impermeable
dressing
• Clean linen provided by outsourced agency must
be packaged before transport to prevent inadvertent
contamination from dust and dirt during loading, delivery and unloading
Monitoring
• The efficiency of the disinfection cycles should be checked when commissioning
new machines, at regular intervals (every 6 weeks) and during outbreak.
• Sampling may be used as part of an outbreak investigation if epidemiologic
evidence suggests that textiles, fabrics or clothing are suspected vehicles for
disease transmission

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CDC - Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008