necessary to ensure outsourced laundries ’ staff follow these best practices during the entire process , from picking up laundry at the facilities to delivering to the laundries and returning hygienic HCTs . The practices must include dedication to properly maintaining , cleaning , and disinfecting equipment and transportation .
In the U . S ., unlike countries of the European Union , healthcare textiles are disinfected using chemicals and thermal processes . Using surfactants , disinfectants , hot water , or water of sufficient temperature to complement detergent efficacy and drying temperatures ensures that HCTs meet the highest possible laundering standards attainable . When laundries choose to use low-temperature water , additional steps and different chemicals are used that result in hygienic results . HCTs that require sterilization are laundered like other HCTs but undergo additional steps to sterilize and pack .
Laundry certification assures hospitals that their HCTs are appropriately collected , sorted , processed , packaged , and delivered to the highest hygienic standards . Following evidence-based practices and scientific principles , including the CDC guidelines , ensures the reduction or elimination of microorganisms , including MERS , SARS , and SARS-CoV-2 . Commercial laundering differs drastically from home laundering practices ( obviously , the machines are larger and more complex ), and those differences ensure scrubs and all other HCTs are consistently more hygienic and better for staff and patients than scrubs and lab coats laundered at home .
Commercial healthcare laundries incorporate the following components in the laundering process :
• Properly programmed machines ensure time , temperature , agitation , and injection of proper chemicals sufficient to remove soils and contaminants from soft surface textiles , patient-use textiles , and healthcare textiles known as healthcare-grade ultra microfiber .
• Properly programmed commercial machines facilitate the removal of bioburdens trapped in textiles and provide sufficient rinses based on load content . CDC guidelines also mandate water temperatures greater than or equal to 160 degrees F . Low-temperature water of 71 degrees to 77 degrees F ( 22-25 degrees C ) with a 125-parts-per-million ( ppm ) chlorine bleach rinse is also an effective way to process laundry .
• Proper pH chemicals – both high pH ( alkaline ) and low pH ( acid ) – to deactivate organisms and viruses . Remember that a virus is not a living organism to be killed
but to be destroyed and removed . Properly introducing chemicals at the appropriate time for an adequate amount of time negatively affects dirt and bioburdens . Controlling the pH levels also ensures that HCTs have a neutral pH and presents no issues to sensitive patient skin .
• Proper oxidation agents also have adverse effects – removing and or destroying pathogens . Commercial laundries have the expertise and chemicals to produce desired results , unlike home washing machines or coin-operated machines for those inclined to require workers to launder their scrubs and uniforms .
• Rinsing is a vital step in the proper laundering of HCTs and cannot be stressed enough . Rinsing ensures that contaminants enter the waste stream .
The final step in the laundering process includes drying HCTs at a temperature that exceeds 160 degrees F at the dryer exhaust . That means the internal drying temperature will far exceed the temperature needed to deactivate or potentially kill any pathogens that have survived the washing cycles . Additionally , sheets and pillowcases encounter the heat of a flatwork ironer that typically is 365 degrees F , depending upon the equipment manufacturer ’ s recommendations and the best practices of the laundry facility .
When it comes to laundering HCTs , including healthcare-grade ultra microfiber textiles , there are five essential processes :
• Proper wash and rinse time ,
• Proper chemical mix and injection time
• Proper agitation time
• Proper loading capacity – don ’ t overload
• Proper drying temperature – don ’ t overload the dryers
Addressing Textiles Used by Environmental Services Personnel
At the time of the introduction of disposable microfiber wipers , mops , and dusters to healthcare , numerous fallacies about reusable microfiber were introduced to environmental services , infection prevention and control , and materials management professionals by the manufacturers of disposable microfiber products . Some of the most notable fallacies include :
• Reusable microfiber should be laundered and returned to clients in a sterile state .
• Returning reusable microfiber in a hygienic state was unacceptable .
• Reusable microfiber material could not easily release the contaminants removed from surfaces during a subsequent reprocessing procedure such as washing .
• Quaternary ammonium compound binding was an issue specific to reusable microfiber textiles but not disposable microfiber textiles .
Why highlight these four fallacies ? Because they are still being repeated by disposable textile proponents and believed by professionals who have not taken the time to educate themselves . There is a place in healthcare for disposable textiles , but environmental services professionals must know the truth . Diab-Elschahawi , et al . ( 2010 ) found that the selection of approved detergent-disinfectants together with the use of appropriate cleaning equipment is an imperative step in assuring a high level of safety and efficacy of the cleaning and disinfection process .
A Few Thoughts About the Covid-19 pandemic
SARS-CoV-2 is especially frightening because it ’ s a specific virus we do not yet know well . But viruses are less complex to deal with these bacterial diseases . When a person contracts COVID-19 or any other disease , physicians must address the entire patient ’ s physiology , including co-morbidities and the effect of their desired interventions and treatments on the patient .
SARS-CoV-2 transmission can occur through indirect contact with surfaces in the immediate environment or with objects used on the infected person , such as stethoscopes , thermometers , or HCTs . Commercial healthcare laundries and laundries that process scrubs , lab coats , and other soft-surface materials have long fulfilled their part of this type of challenge by serving as significant partners with hospitals and other healthcare facilities . Their processes ensure that HCTs are hygienic and are current with the latest CDC guidelines .
John Scherberger , FAHE , CMIP , T-CHEST , T-CSCT , T-CNACC , VPEI , is principal of Healthcare Risk Mitigation and a board member of the Environmental Services Optimization Project ( EvSOP ).
References : de Oliveira AC , et al . Healthcare professionals ’ clothing as potential reservoirs of microorganisms : an integrative review . Literature Review . Sep 2012 . https :// doi . org / 10.1590 / S0104-07072012000300025
Diab-Elschahawi , et al . Evaluation of the decontamination efficacy of new and reprocessed microfiber cleaning cloth compared with other commonly used cleaning cloths in the hospital . Am J Infect Control . May 2010 .
Jagger J , Caring for Healthcare Workers : A Global Perspective . Infect Control Hosp Epidemiol . Vol . 28 , No . 1 . January 2007 .
Riley K , et al . Washing uniforms at home : adherence to hospital policy . Nursing Standard . 2015 Feb 20 ; 29 ( 25 ): 37-43 . doi : 10.7748 / ns . 29.25.37 . e9268 .
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