Best practices to prevent infections during healthcare laundry process

June 30, 2015

A new review has suggested best practice for proper laundering and handling to prevent infections being spread.

Published in the journal of the Society for Healthcare Epidemiology of America (SHEA), the review is based on findings and recommendations from peer-reviewed studies, as well as current standards and guidelines.

The report highlights the importance of proper laundering and handling to achieving and maintaining the high standards needed for healthcare fabrics and textiles delivered to the point of care, according to a new review that highlights evidence-based strategies to inhibit potentially serious contamination. 

Lead author of the review Dr Lynne Sehulster, who is an infectious disease epidemiologist at the Centers for Disease Control and Prevention (CDC), said the evidence suggests that current industrial laundry processes are sufficient to interrupt patient-to-patient transmission via clean healthcare textiles (HCT). 

The study, according to Dr Sehulster, could find no evidence of microbial carry-over from one patient to the next for patient-care textiles when proper textile management and laundering specifications were used.

Reassuringly, cases of outbreaks of infectious diseases resulting from laundered HCT are rare, with just 12 being reported in the last four decades. However, there are also instances where clean healthcare textiles have been inadvertently exposed to environmental contamination, including dust in storage areas or a process failure during laundering.

Dr Sehulster said: "Current infection prevention strategies for laundering and handling HCT appear to be adequate in preventing healthcare-associated infections, provided that every step is taken to maintain the hygienic quality of HCTs prior to use. 

"However, if an outbreak occurs linked to HCT, it is not enough to conduct microbial sampling of laundered textiles and declare the laundry process to be the source of the problem. Each of the distinct operations of the laundry-handling process needs to be evaluated in order to pinpoint the root of the problem."

She said the review was limited to clean HCT from laundries, meaning future studies will need to be conducted to look at contamination that occurs while the HCT are in use. 

According to the review, recommendations on optimal infection-prevention strategies used during the laundering process of HCT include:
Adherence to Standard Precautions (gown and gloves) and minimal textile agitation when handling contaminated laundry in isolation rooms are considered sufficient to prevent the dispersal of potentially infectious aerosols.
Offsite laundries should carefully package or cover clean textile bundles prior to transport to prevent inadvertent contamination from dust and dirt during loading and unloading.
Laundered HCT must be stored in a manner to keep them dry and free from soil contamination.
If alterations occur in water temperature, agitation, chemical type and concentration, and duration of laundering cycle, the addition of a disinfecting laundry chemical can compensate for the anticipated loss of antimicrobial effectiveness of the overall process.
Laundry additives, such as hydrogen peroxide, peracetic acid and acetic acid, can provide extra disinfection options for short wash cycles of HCT or for those laundry situations in which chlorine bleach is not indicated.
Industrial laundering offers more control of the process and can be tailored to adequately disinfect HCT with more choices of detergent and laundry additives compared to home laundering.
The importance of temperature, relative humidity, and moisture control in storage areas is central to preventing microbial proliferation in and on materials that have some organic components.

However, as new technologies and innovative strategies are developed to control infections in textiles, more research is needed. 

"Studies are needed to demonstrate an impact on healthcare-associated infection incidence and increased patient safety in a cost-effective manner," Dr Sehulster said.

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