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					Laundry policy
                                                                                     ICC 03




                  POLICY: Management of Laundry



Document Reference:            Infection Control

Point of Reference:            Peter Walsh, Director for Infection Prevention and Control
Status:                        Final
Date of Issue:                 May 2006
Date of Review:                May 2008
Policy Reference:              IC 03
Ratified by:                   Clinical Governance Committee



Approved at Clinical Governance Committee Meeting




Signed By
Executive Director of Nursing
Central and North West London Mental Health NHS Trust




Signed By
Medical Director : Chair of Clinical Governance Committee.
On Behalf of Chief Executive
Central and North West London Mental Health NHS Trust




   This policy is based on previous work by the Infection Control team at Westminster and
                            Kensington and Chelsea Primary Care Trusts.



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Contents


                                                        Page number


1.     Rationale                                        3

2.     Aim                                              3

3.     Legal framework                                  3

4.     Handling dirty linen                             3

5.     Categorisation and segregation of linen          4

6.     The laundering process                           5

       6.1 bed linen                                    5
       6.2 personal items                               5
       6.3 uniforms                                     6
       6.4 curtains / soft furnishings                  6
       6.5 pillows                                      6
       6.6 manual handling equipment                    6
       6.7 mop heads                                    6

7.     On-site laundry facilities                       6

8.     Use of linen within community settings,          7
       e.g. health centres

9.     Advice on dealing with soiled / infected linen   8
       in the patient’s home

11.    References                                       8



Appendix

1.     Colour coding for laundry bags                   9




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1.     Rationale

The provision of clean linen is a fundamental requirement for patient care.
Incorrect procedures for handling or processing of linen can present an
infection risk both to staff handling and laundering linen, and to patients who
subsequently use it. This policy describes the steps which must be taken to
minimise this risk.


2.     Aim

To describe the responsibilities of managers and staff for correct handling and
processing of contaminated laundry, to minimise infection risk throughout
Central and Northwest London Mental Health NHS Trust.


3.     Legal framework

Health and Safety at Work etc Act (1974) and Management of Health and
Safety at Work Regulations (1999)

Control of Substances Hazardous to Health Regulations (2002)

Controls assurance standard for infection control, Department of Health
(2002)


4.     Handling dirty linen

 4.1 All dirty linen must be handled with care, to minimise transmission of
micro-organisms 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 patient. Dirty linen must
never be transported around the care environment unless it is within an
appropriately colour coded linen bag. The use of a wheeled linen skip will
protect the bags from damage and keep them off the floor.

4.2 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 patient,
disposable gloves must be worn.

4.3 Care must be taken to remove any extraneous items from dirty linen
before it is placed in laundry bags. Such items are potentially dangerous to
staff handling the laundry, and may also damage laundry equipment.

4.4 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

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laundry. Vehicles or trolleys used for the transportation of dirty linen must be
easy to clean, and must never be used to transport clean linen.


5. 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:

5.1 Clean / Unused Linen

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. It must not be stored within the
sluice or bathroom. Linen cupboard doors must be kept closed to prevent
airborne contamination.

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 contractor and by staff.


5.2 Soiled / Infected Linen

 This is any used linen which is soiled with blood or any other body fluid; and
all linen used by a patient with a known infection (whether soiled or not).

All soiled / infected linen must be placed in a red soluble alginate bag, inside a
clear plastic laundry bag. The soluble bag must be placed directly into the
washing machine 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.

5.3 Dirty / Used Linen

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
on-site or by the laundry contractor.

Used linen bags must be stored in a secure area, away from public access,
whilst awaiting collection.

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See Appendix 2       Colour Coding for Laundry Bags

6.The laundering process

Many micro-organisms will be physically removed from linen by 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.

6.1Bed linen

All hospital bed linen must be laundered by a laundry contractor (?). The
Infection Control Team must be consulted on the negotiation of any contract /
specification for laundry services.

6.2.Personal items

 6.2.1 All personal items of clothing which cannot be taken home by visitors /
relatives, should be laundered on-site. Care should be taken to ensure that
they are not sent to the off-site contractor.

 6.2.2 Personal items must be bagged as above, before being transported to
the laundry room. Each patient’s items must be bagged and washed
separately on the appropriate cycle.

6.2.3 In hostel and more independent accommodation an individual plastic
linen basket should be in each bedroom with a clear plastic linen bag in each.
Staff should ensure that washing takes place at least weekly and more
frequently if linen/ personal items are solied.

6.2.4Manual 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 the washing machine drum.

6.2.5 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 labile items should be washed on the hottest cycle possible for that item.

6.2.6 If soiled items are taken home by relatives for laundering, no pre-
washing or soaking of the item must take place in the clinical area. If alginate
bags are provided for use in domestic machines, they must be the type with a
dissolvable seam, as fully soluble bags may cause blockage. Soiled items
should not be left for more than 24hours. There should be local policies
ensuring relatives are aware soiled items will be laundered on site after 24
hours and it is preferable it is agreed that all soiled personal items are
laundered on site.

6.3Uniforms                                                   see Appendix 1


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Uniforms and clothes of clinical staff must be changed daily.

If uniforms are not sent to the laundry service, they should be washed at
home, separately from other items, and must be washed as 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 an alginate bag. Ideally, it should be sent to the laundry service or to
an on-site laundry, rather than taken home.

If alginate bags are provided for use in domestic machines, they must be the
type with a dissolvable seam, as fully soluble bags may cause blockage.

6.4 Curtains / Soft Furnishings

Curtains in clinical areas must be laundered on a quarterly basis and when
soiled. Any curtains purchased for clinical areas must be machine washable.

Within clinical areas, soft furnishings such as chairs must be purchased with
fluid repellent upholstery. Any stained or soiled chairs should be steam
cleaned, re-upholstered or discarded as soon as possible.

6.5 Pillows

Pillows must not be laundered. All pillows must be covered with an impervious
waterproof cover. If the pillow itself becomes soiled, it must be discarded as
soon as possible.

6.6 Manual handling equipment

Patients should have either their own hoist sling or a disposable sling until
discharge from hospital, when this should be laundered or disposed of, as
appropriate. Patients should have their own sliding sheet if required, which
should be laundered on discharge from hospital. Where there is any soiling of
fabric items, they must be laundered immediately and must not be washed by
hand in the department.

6.7 Mop heads

Mop heads must be machine washed on a weekly basis, separately from
other items in a designated mop head washing machine.


7. On - site laundry facilities

 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 or to clients who are performing their own laundry.

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 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. No eating, drinking or smoking is
permitted in the laundry.

The design of the laundry should facilitate the creation of clean and dirty
areas, i.e. dirty linen can be brought into the laundry, processed and come out
as clean linen, without it becoming contaminated by dirty linen.

7.1 Soiled or infected linen (which should be placed into the machine in a red
alginate 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.

7.1.1 Laundry bins should be cleaned with hot water and detergent at least
weekly. Washing machines should be disinfected weekly by running a hot
programme without a load.

7.2 On-site laundries must have the following facilities and equipment:

 Washing machine/s (industrial type with a sluice cycle)
 Tumble drier/s
 Hand washing sink with lever-operated mixer taps, liquid soap and paper
  hand towels
 A pedal/sensor-operated bin for paper towels
 A pedal/sensor-operated clinical waste bin
 Disposable gloves
 Disposable 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
 Ironing and folding area

7.3 Staff who undertake laundry duties must be fully trained and fully
immunised against hepatitis B. They should be aware of the risk of sharps in
laundry and the actions to take in the event of a sharps injury or other
exposure to blood or body fluids.

 7.4 All washing machines and driers must be subjected to a planned
programme of service and maintenance at least annually via the Estates
Department. Hotel Services must keep records of all service and maintenance
history on each site.

8.Use of linen within community settings, e.g. health centres ??

Fabric sheets and blankets must only be used within community health care
settings if a laundry service is available. Laundry should be changed at least
daily, and if soiled. Alternatively, disposable sheets and pillow cases may be

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purchased. Paper couch roll should be used as a covering for examination
couches.

Examination couches and pillows must have intact impervious coverings, so
that they are not contaminated in the event of a spillage of blood or body
fluids.


9 .Advice on dealing with soiled / infected linen in the patient’s home

In the patient’s home or in hostel accommodation or ‘activities of daily living’
kitchens, the washing machine may be in the kitchen. If soiled or infected
linen needs to be washed, this should not be done at the same time as food is
being prepared. In the Trust care homes, Activities and Daily Living kitchens
and in hostel accommodation, the washing machine should not be placed with
in the food preparation areas of the kitchen. Soiled or infected linen should be
washed separately, after all other laundry, using the hottest wash possible for
the fabric. Overloading of the machine should be avoided.

Hands should be washed after any contact with dirty linen, and gloves and
apron worn for any contact with blood or body fluids.




10.    References

NHS Executive. Hospital Laundry Arrangements for Used and Infected Linen.
Health Service Guidelines. HSG (95) 18; 1995.




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Appendix 1


                      COLOUR CODING FOR LAUNDRY BAGS


       SOILED / INFECTED LINEN   INSIDE             RED BAG      OUTSIDE   CLEAR BAG
                                                    (Alginate)




    ALL OTHER USED LINEN
                                                   CLEAR BAG




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