Infection Control
Laundry Guidance
To be read in association with:
Communicable Diseases Policy
Environmental Policy & Objectives
Hypodermic Syringes and Needle Stick Injury and Disposal - Guidance
COSHH Policy
Infection Outbreak Control Guidance and Procedures
Review date: Dec 2011
Nov09/ver01
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Contents
Page
1
Introduction
4
2
Aim
4
3
Objectives
4
4
Legislative framework
4
5
Staff handling of dirty linen
4
6
Categorisation and segregation of linen
5
7
The laundering process
6
8
On-site laundry facilities
7
9
Reference Material
8
10
Appendix 1 - Advice to staff on the laundering of uniforms
9
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1. Introduction
The provision of clean linen is a fundamental requirement for residential care.
Incorrect procedures for handling or processing of linen can present an infection
risk both to staff handling and laundering linen, and to the residents who
subsequently use it. This document describes the steps which must be taken to
minimise this risk. The guidance will also ensure that any contracted services will
be required to have quality systems in place.
2. Aim
To describe the responsibilities of managers and staff for correct handling and
processing of contaminated laundry, to minimise infection risk throughout Nugent
Care. This guidance should be followed in conjunction with other Nugent Care
policies, where appropriate.
3. Objectives
To protect staff and service users from any infection risk from used linen and to
significantly reduce the number of micro-organisms on linen
4. Legislative framework
The Health and Social Care Act
Health and Safety at Work etc Act
Management of Health and Safety at Work Regulations
Control of Substances Hazardous to Health Regulations
5. Staff handling of dirty linen
All dirty linen must be handled with care, to minimise transmission of
microorganisms via dust and skin scales.
Plastic disposable aprons must be worn when there is potential for contamination
of the clothing, i.e. when changing beds.
All dirty linen must be placed carefully and directly into the appropriate laundry
bag on removal from the bed or service user.
Dirty linen must never be transported around the care environment unless within
a linen bag and appropriately labelled.
Transportation of linen between premises or to and from the laundry area must
be in accordance with the Nugent Care procedure and guidance.
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Hands must be washed immediately following the handling of any dirty linen. If
linen is soiled with blood or body fluids, or from an infected service user,
disposable gloves must be worn.
Care must be taken to remove any non-laundry items from dirty linen before it is
placed in laundry bags. These can cause injuries to staff handling the laundry,
and may also damage laundry equipment.
To avoid spillage of dirty linen, linen bags must never be more than two thirds
full, and must be securely tied with a knot prior to transport to the laundry and
appropriately labelled.
Bins or trolleys used for the transportation of dirty linen must be easy to clean,
and must never be used to transport clean linen.
6. Categorisation and segregation of linen
It is the responsibility of the person disposing of the linen to ensure that it is
segregated appropriately. All linen can be categorised into the following three
groups:
a) Clean or unused linen
b) Soiled or infected linen
c) Dirty or used linen
a, Any linen that has not been used since it was last laundered.
All clean linen must be stored off the floor in a clean, closed cupboard, and must
be segregated from used / soiled linen. Linen cupboard doors must be kept
closed to prevent airborne contamination. Linen must not be stored within the
sluice or bathroom.
If taken into an isolation room and not used, linen must then be laundered before
use.
Clean linen must be in a good state of repair, as tearing or roughness can
damage the patient’s skin. The condition of linen in use should be monitored by
the laundry staff.
b, Any used linen which is soiled with blood or any other body fluid.
The above categorisation includes all linen used by a service user with a known
infection (whether soiled or not).
All soiled / infected linen must be placed in a soluble bag, inside a clear plastic
laundry bag. The soluble bag must be placed directly into the washing machine
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to minimise contact and prevent transmission of infection to laundry staff or
contamination of the environment. The outer clear plastic bag should be
disposed of as clinical waste.
c, All used linen other than that listed above.
All linen that falls within this category must be placed within a clear plastic
laundry bag.
This system of categorisation applies whether the items are being laundered onsite or by the laundry contractor.
Bags of dirty / used or soiled / infected linen must be stored in a secure area,
away from public access, whilst awaiting collection.
7. The laundering process
During the laundering process many micro-organisms will be physically removed
from linen by the detergent and water, and most are destroyed by a high
temperature wash. Any remaining micro-organisms are likely to be destroyed by
tumble drying and ironing.
Bed linen - All bed linen must be laundered by the designated on site laundry
worker in the facility provided.
Personal items - All personal items of clothing, which are not taken home for
laundering by visitors / relatives, should be laundered on-site.
Personal items, as above, must be bagged before being moved to the laundry.
Each resident’s items must be bagged and washed separately on the appropriate
cycle.
Manual soaking / washing of soiled items must never be carried out. A sluice
cycle or cold pre-wash must be used for all soiled items.
Care should always be taken not to overfill or under-fill the washing machine
drum.
Heat resistant items must be processed in a cycle which reaches 71ºC (for not
less than 3 minutes) or 65ºC (for not less than 10 minutes).
Heat labelled items should be washed on the hottest cycle possible for that item.
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If soiled items are taken home by relatives for laundering, no pre-washing or
soaking of the item must take place. If soluble bags are provided for use in
domestic machines, they must be the type with a dissolvable seam, as fully
soluble bags may cause machine blockage.
The work uniforms of staff must be changed daily. It is recommended that staff
send their uniforms to the laundry for cleaning, where available, to ensure
thorough cleaning.
If uniforms are not sent to the laundry service, they should be washed at home,
separately from other items, and must be washed as per the instructions for heat
resistant personal items above (with a cold pre-wash if soiled).
If a uniform becomes contaminated with blood or body fluid, it must be changed
for a clean one as soon as possible. It may therefore be necessary to keep a few
spare uniforms at each site. The contaminated item should be placed in a soluble
bag. Ideally, it should be sent to the on-site laundry, rather than be taken home.
If dissolving bags are provided for use in domestic machines, they must be the
type with a dissolvable seam, as fully soluble bags may cause blockage.
Curtains / Soft Furnishings - Curtains in the premises should be laundered on a
six monthly basis or when soiled or potentially contaminated through contact with
an infected material or service user.
Any curtains purchased for the premises must be machine washable.
Alternatively, the use of disposable curtains may be considered. Only curtains
purchased by Nugent Care can be used in the establishments.
Soft furnishings such as chairs should be purchased with wipe-able coverings.
Any stained or soiled chairs should be steam cleaned or discarded as soon as
possible. Steam cleaning should be carried out by a cleaning specialist in
accordance with the approved contract specification determined by Purchasing.
Pillows - Pillows must never be laundered. All pillows must be covered with an
impervious waterproof cover. If the pillow itself becomes soiled, it must be
discarded.
Manual handling equipment
Service users may be provided with either their own hoist sling or there should be
a suitable cleaning regime in place for the use of shared slings or disposable
slings may be used, as appropriate.
Service users must have their own sliding sheet if required, which must be
laundered regularly.
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Where there is any soiling of fabric items, they must be laundered immediately
and must not be washed by hand.
Mop heads - Mop heads must be machine washed on a weekly basis, separately
from other items, unless they are of a disposable type.
8. On-site laundry facilities
No washing machine must be purchased without the involvement of the
Purchasing Manager.
An on-site laundry must be situated within a designated room that is used for
laundry purposes only. Access to this room should be limited to staff involved in
the laundry process.
The room should be well lit and well ventilated. The floors, walls, splash-backs
and work surfaces must be impervious and easy to clean. Cleaning of the room
should take place on a daily basis. Eating or drinking is not permitted in laundry
rooms.
The design of the laundry should accommodate the need for clean and dirty
areas, i.e. dirty linen can be brought into the laundry, processed and come out as
clean linen, without it becoming re-contaminated by dirty linen.
Soiled or infected linen (which should be placed into the machine in a soluble
bag) should be washed separately, after all other laundry, using the hottest wash
possible for the fabric. The washing machine must not be overloaded. Hands
should be washed after any contact with dirty linen, and gloves and apron worn
for any contact with blood or body fluids.
Laundry bins should be cleaned with hot water and detergent at least weekly.
Washing machines should be disinfected weekly by running a hot program
without a load.
On-site laundries must have the following facilities and equipment:
.. Washing machines (industrial type) and tumble drier/s
.. Hand washing sink with lever-operated mixer taps, liquid soap and paper hand
towels
.. A pedal-operated bin for paper towels
.. A pedal-operated clinical waste bin
.. Disposable gloves and plastic aprons
.. Waterproof plasters (so that staff can cover cuts or abrasions)
.. Segregated area for dirty linen / linen skips
.. Segregated area for clean linen storage
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.. Ironing and folding area
Employees, who undertake laundry duties, must be fully trained in the relevant
safe working practices.
They should also be aware of the risk of sharps or needles hidden within laundry
and the actions to take in the event of a sharps injury or other exposure to blood
or body fluids.
All washing machines and driers must be subject to a planned program of service
and maintenance at least annually; this should be arranged via Property
Services.
9. Reference Material
Health Service Guidance “Hospital Laundry Arrangements for Used and Infected
Linen”, HSG (95) 18.
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Appendix 1
Advice to staff on the laundering of uniforms
Uniforms of staff (where provided) must be changed daily. It is recommended
that staff send their uniforms to the on site laundry for cleaning, where available.
If uniforms are not sent to the on site laundry they should be machine washed at
home, separately from any other items. They must be washed on a machine
cycle that reaches 71ºC (for not less than 3 minutes) or 65ºC (for not less than 10
minutes).
If a uniform becomes contaminated with blood or body fluid, it must be changed
for a clean one as soon as possible. Therefore it will be necessary to keep a few
spare uniforms at each site. The contaminated item should be placed in a
dissolvable bag. Ideally, it should be sent to the laundry, rather than taken home.
If the uniform is taken home, it should be washed separately from other items on
a hot wash, as described above.
If soluble bags are provided for use in domestic machines, they must be the type
with a dissolvable seam, as fully soluble bags may cause machine blockage.
The above principles also apply to the laundering of care workers’ own clothing if
worn for work. Clothing should be worn that can withstand domestic laundering at
60ºC.
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