folding stations . As with surfaces , choose a variety of locations and regularly test for contamination . Define the test method and define the acceptable contamination values . Contamination values found above acceptable levels mean air cleaning protocols need to be re-evaluated . Air filters or air handlers may need adjustment ( equipment ); Blowdown frequency may need to be increased ( process ); or cleaning personnel may need additional training ( people )
u Process water
Clean process water is a necessary ingredient in producing clean HCTs . Good places to test process water cleanliness include the main city water supply , cold process water tanks , and final rinse water zones in a tunnel washer . Water should be tested at least monthly and acceptable contamination values should be set . Water contamination values found above acceptable levels mean water protocols need to be re-evaluated . Dirty city water may need additional filtration or treatment ( equipment ); Dirty clean water tank storage means tank cleaning procedures must be re-evaluated ( people / process ); Dirty final rinse zones means dirty water will re-contaminate HCT . Tunnel tank cleaning protocols must be re-evaluated and personnel re-trained on these ( people / process / equipment )
u Employee hands
Laundry-finish personnel often touch clean HCT . If their hands are dirty , they will re-contaminate the clean HCT . While it is unrealistic to test every finish-employee ’ s hands every minute of every day , it is a good idea to sample a few employee hands regularly . Define the test method and define the acceptable contamination values . Contaminated hand values found above acceptable levels mean hand hygiene protocols , equipment , and training must be reassessed ( people / process / equipment ).
u Finished HCT
The final step in a laundry process monitoring program is to test the bioburden levels on the finished HCT . Once again , strategic sampling is our best solution . Choose several different textile blends including 100 percent cotton items ( e . g ., OR towels ), polyester cotton blends ( e . g ., blankets , sheets , towels ), and 100 % synthetic items ( e . g ., surgery gowns , isolation gowns ). Test regularly and be sure they are sampled as close to patient end use as possible . Define the test method and define the acceptable contamination values . Contaminated HCT values found above acceptable levels mean the process needs to be re-assessed . First test the HCT out of the wash to ensure they are within acceptable levels . If not , there is an issue with the wash process that must be addressed . If HCT out of the wash are clean , then the problem lies downstream . Check air , surface , and employee hands for areas where re-contamination may be occurring . Hopefully , our other process monitoring steps have already identified these .
How to test ? Tap the latest resources
https :// www . pmtknet . org ) that meets the above criteria and is made for healthcare laundry process monitoring . I suggest giving it a try .
How do we define acceptable contamination levels ?
Generally , acceptable contamination criteria do not exist yet for healthcare laundry . Consequently , they must be defined internally and then measured against . As more laundries implement process monitoring and more data is gathered , our industry can develop more accurate contamination standards . It is a good idea to involve hospital infection prevention personnel in any exercises where acceptable contamination criteria are determined . It is also important to note that not all areas and items will have the same contamination criteria . For example , certain areas of a hospital that house immunosuppressed patients may require sterile HCTs . These items must have zero contamination and thus must be handled differently than normal HCT . Incoming city water will most likely have different acceptable contamination levels than tunnel washer press tank water . Soil sort conveyer acceptable contamination levels will certainly be different from those on clean linen carts . The important practice is to define your acceptable contamination levels , measure to them , and then adjust / manage your process when actual levels fall outside of acceptable levels . Then repeat !
Putting it all together
Healthcare laundry process monitoring is the surest way to ensure standard laundry processes consistently provide hygienically clean and safe HCTs for sick patients . Best practices for implementing a laundry process monitoring program are built around :
1 . Defining areas to test . We recommend hard surfaces , air , water , employee hands , and linen
2 . Setting testing frequency . We recommend linen at least quarterly ; other areas at least monthly
4 . Setting acceptable contamination levels across areas – We recommend defining these internally with your hospital infection prevention partners .
5 . Managing to acceptable contamination levels – Make process , equipment , and people adjustments when acceptable levels are not met
6 . Repeat the process
The end result is that hospital patients and their families will thank you for providing them with consistently clean linen and giving them one less thing to worry about as they heal .
Gregory Gicewicz is distinguished in the reusable textile industry as a tireless advocate for increasing awareness of the significant role that having high standards in the processing of healthcare laundry plays in broader infection prevention strategy . He is president and CEO of Sterile Surgical Systems , a full-service accredited healthcare laundry and reusable sterile surgical textile pack manufacturer . He is past-president of the Healthcare Laundry Accreditation Council ( HLAC ), currently serves as HLAC inspection committee chair , and led a committee that developed the HLAC Laundry Process Monitoring Toolkit .