Laundering and Safe Handling of Linen and Clothing Ref IPC-0001-008 v2.1 Status: Approved Document type: Procedure
Contents 1 Purpose... 3 2 Related documents... 3 3 How to handle and safely launder linen and clothing... 3 3.1 Security and labelling... 3 3.2 On site laundry... 3 3.3 Recommended temperatures and cycle times... 4 3.4 Washing machines non industrial (domestic)... 4 3.5 Patient s Clothing... 4 3.6 Laundry bag colour codes... 5 3.7 Sharps... 5 3.8 Staff Health... 6 3.8.1 Staff Health in Units Dealing with Laundry (including patient clothing)... 6 3.9 Duvets and Pillows... 6 4 Definitions... 7 5 References and further reading... 7 6 Equality Analysis Screening Form... 8 7 Document control... 12 Ref IPC-0001-008 v2.1 Page 2 of 12 Ratified date: 27 July 2016
1 Purpose Following this procedure will help the Trust to:- Separate used linen into the correct bag(s); Wash at the correct temperature in order to minimise the risk of infection. 2 Related documents This procedure describes what you need to do to implement the laundering and handling of safe clothing section of the Infection Prevention and Control Policy The Standard (Universal) Precautions for Infection Prevention and Control defines the universal standards for IPC which you must read, understand and be trained in before carrying out the procedures described in this document. 3 How to handle and safely launder linen and clothing 3.1 Security and labelling You must: Fasten bags containing laundry securely before transporting to a laundry, or within an onsite unit; Only fill the laundry bags ¾ full to comply with the manual handling policy. This will also prevent spillage from the laundry bag. 3.2 On site laundry Where laundering has been agreed and is carried out within units or wards, the following principles apply: The washing machine must be capable of providing the recommended washing temperatures and have a pre-wash cycle; Keep the laundering area separate from kitchens and other clinical rooms. Within rehabilitation/activity of daily living settings it may be necessary to have laundry facilities to emulate normal domestic surroundings; Laundry facilities should not be found in sluice/dirty utility areas; The laundering area should allow proper segregation of clean and dirty laundry; Hand washing facilities must be available; Ref IPC-0001-008 v2.1 Page 3 of 12 Ratified date: 27 July 2016
Protective clothing must be available for staff (apron and gloves); Suitable receptacles/containers for clean/dirty linen must be provided; & these should be cleaned each time dirty laundry is removed from them. Do not use a domestic washing machine for bed linen sheets and towels and Kylies (draw sheets) as the temperatures may not achieve the correct disinfection temperature; All sheets and towels must be sent to a central laundry with the exception of areas with agreement from the infection prevention and control team. 3.3 Recommended temperatures and cycle times The washing process: Requires a disinfection cycle in which the temperature is maintained at 65 o C (150 o F), for no less than 10 minutes or preferably 71 o C (160 o F) for no less than 3 minutes; Conventional machines e.g. load below 0.056kg, 4 minutes should be added to the above cycle times, above 0.056kg, 8 minutes should be added. A sluice cycle is required when dealing with fouled linen. 3.4 Washing machines non industrial (domestic) Advice should be sought from Infection Prevention and Control when purchasing nonindustrial machines. During outbreaks of infection it may be advisable for linen to be laundered off site depending on the severity of the outbreak. Off site laundering will be arranged by Hotel Services/Infection Prevention and Control staff. 3.5 Patient s Clothing Patient clothing is normally washed at low temperature, 40 o C (104 o F), to avoid damage; 40 o C (104 o F) is sufficient to remove micro organisms, particularly in domestic style washers; Temperature in tumble dryers must be limited to 60 o C (140 o F); Patients clothing laundry bags ( Dissolvo Sacks are available from supplies). All patients clothing should be washed separately from other patients clothing. Launder clothing that is heavily contaminated with body fluids separately. Ref IPC-0001-008 v2.1 Page 4 of 12 Ratified date: 27 July 2016
3.6 Laundry bag colour codes Type Category Bag Sheets/Towels etc Used White Sheet/Towels contaminated with blood and body fluids Fouled / Infected Red water soluble Patient Clothing Used White Patient Clothing Fouled / Infected Red water soluble/patients clothing bag white with orange stripe There are two types of red water-soluble bags: 1. Dissolvo Sack 2. Aquafilm Soluble Laundry Bags Dissolvo Sack Designed for hot and cold temperature, washes 40 o C and above; The soluble strip is released when in the machine; The bag is retrieved after the wash cycle and disposed of; This type is mainly used for patient clothing; Ordered through supplies as Dissolvo Sacks (Code DS002 for size 28cms x 30xcms). Aquafilm Soluble Laundry Bag Designed to be totally soluble and biodegradable; The bag is placed directly into the machine and, during the wash, the bag disperses; The bags are hot water soluble, suitable for washes at 65 o C and above; They are not suitable for use in domestic type washing machines; Ordered through supplies as Aquafilm Soluble Laundry Bags (Code LH020 (MUF056) Size 66cms x 84 cm). 3.7 Sharps You must take extreme care to ensure no sharp instruments, needles or equipment are enclosed in linen being transported for laundering; You must report any items found, to the Unit Manager to allow steps to be taken to investigate the source. For further information please refer to Safe use of Sharps Ref IPC-0001-008 v2.1 Page 5 of 12 Ratified date: 27 July 2016
3.8 Staff Health All staff must wear aprons/overalls and gloves when handling used/fouled or infected linen; Proper protection must be used at all times; You must cover exposed skin lesions, eczema or psoriasis with a waterproof dressing Before handling used/fouled of infected linen. 3.8.1 Staff Health in Units Dealing with Laundry (including patient clothing) You must: Ensure that no manual sluicing of items takes place; Use laundry/plastic bags to transport linen; Wear gloves and aprons when dealing with laundry; Ensure staff with unhealed lesions, rashes or other skin conditions should not handle clean laundry unless the lesions are covered with a waterproof dressing; Wash your hands after removing protective clothing and after handling linen. 3.9 Duvets and Pillows Fabric Duvets and Pillows Must be able to withstand 71 o C; Must be washed between patients; Must be washed when soiled; Must be washed at least once every three months. PVC Coated Duvets and Pillows Must be cleaned with detergent and water between patient use. Must be discarded if unable to clean effectively eg body fluid stains. Ref IPC-0001-008 v2.1 Page 6 of 12 Ratified date: 27 July 2016
4 Definitions Term Fouled Infected Used Definition Used linen contaminated by blood, body fluids or excreta Used linen from patient with a specified infection which has the potential to infect patients and staff Includes all used linen, irrespective of state 5 References and further reading NHS Executive (1995) Hospital Laundry Arrangements for Used and Infected Linen HSG (95) 18 HMSO London Wilson J (2001), Infection Control in Clinical Practice Balliere Tindall 2 nd Ed. London (Pg 149) DoH (2006) Essential steps to safe, clean care. Reducing healthcare-associated infections in Primary Care Trusts; Mental Health Trusts; Learning disability organisations; Independent Healthcare; Care Homes; Hospices; GP Practices and Ambulance Services Department of Health (2008) The Health and Social Care Act 2008 Code of Practice for the Prevention and Control Health Care Associated Infection London DH 2016 Ref IPC-0001-008 v2.1 Page 7 of 12 Ratified date: 27 July 2016
6 Equality Analysis Screening Form Please note; The Equality Analysis Policy and Equality Analysis Guidance can be found on InTouch on the policies page Name of Service area, Directorate/Department i.e. substance misuse, corporate, finance etc. Nursing and Governance/IPC and Physical Healthcare Name of responsible person and job title Name of working party, to include any other individuals, agencies or groups involved in this analysis Elizabeth Moody, Director of Nursing and Governance Elizabeth Moody, Dr D Allison, Dr R Bellamy, Angela Ridley, Emma Rolfe and the Infection Prevention and control Committee Policy (document/service) name Is the area being assessed a; Policy/Strategy Service/Business plan Project Procedure/Guidance Code of practice Other Please state Geographical area Trustwide Aims and objectives Start date of Equality Analysis Screening (This is the date you are asked to write or review the document/service etc.) End date of Equality Analysis Screening (This is when you have completed the analysis and it is ready to go to EMT to be approved) To set standards in practice to ensure the delivery of patient care is carried out safely and effectively by the trust staff. To comply with the HCAI Code of Practice of the Health and Social Care Act 2008. 26 th July 2016 11 th August 2016 Ref Page 8 of 12 Ratified date: Title Last amended:
You must contact the EDHR team as soon as possible where you identify a negative impact. Please ring Sarah Jay or Tracey Marston on 0191 3336267/3542 1. Who does the Policy, Service, Function, Strategy, Code of practice, Guidance, Project or Business plan benefit? Trust staff and patients 2. Will the Policy, Service, Function, Strategy, Code of practice, Guidance, Project or Business plan impact negatively on any of the protected characteristic groups below? Race (including Gypsy and Traveller) Yes/ Disability (includes physical, learning, mental health, sensory and medical disabilities) Yes/ Gender (Men, women and gender neutral etc.) Yes/ Gender reassignment (Transgender and gender identity) Yes/ Sexual Orientation (Lesbian, Gay, Bisexual and Heterosexual etc.) Yes/ Age (includes, young people, older people people of all ages) Yes/ Religion or Belief (includes faith groups, atheism and philosophical belief s) Yes/ Pregnancy and Maternity (includes pregnancy, women who are breastfeeding and women on maternity leave) Yes/ Marriage and Civil Partnership (includes opposite and same sex couples who are married or civil partners) Yes/ Yes Please describe anticipated negative impact/s Please describe positive impacts/s barriers to access or implementing this procedure. Ref IPC-0001-008 v2 Page 9 of 12 Ratified date: 27 July 2016
3. Have you considered other sources of information such as; legislation, codes of practice, best practice, nice guidelines, CQC reports or feedback etc.? If, why not? Sources of Information may include: Feedback from equality bodies, Care Quality Commission, Equality and Human Rights Commission, etc. Investigation findings Trust Strategic Direction Data collection/analysis National Guidance/Reports Yes Staff grievances Media Community Consultation/Consultation Groups Internal Consultation Research Other (Please state below) 4. Have you engaged or consulted with service users, carers, staff and other stakeholders including people from the following protected groups?: Race, Disability, Gender, Gender reassignment (Trans), Sexual Orientation (LGB), Religion or Belief, Age, Pregnancy and Maternity or Marriage and Civil Partnership Yes Please describe the engagement and involvement that has taken place Please describe future plans that you may have to engage and involve people from different groups t relevant to this procedure Ref IPC-0001-008 v2 Page 10 of 12 Ratified date: 27 July 2016
5. As part of this equality analysis have any training needs/service needs been identified? Yes/ Please describe the identified training needs/service needs below t relevant to this procedure. A training need has been identified for; Trust staff Yes/ Service users Yes/ Contractors or other outside agencies Yes/ Make sure that you have checked the information and that you are comfortable that additional evidence can provided if you are required to do so The completed EA has been signed off by: You the Policy owner/manager: Type name: Elizabeth Moody Date: 11/8/16 Your reporting (line) manager: Type name: Angela Ridley Date: 11/8/16 If you need further advice or information on equality analysis, the EDHR team host surgeries to support you in this process, to book on and find out more please call: 0191 3336267/6542 or email: traceymarston@nhs.net Ref IPC-0001-008 v2 Page 11 of 12 Ratified date: 27 July 2016
7 Document control Next review date: 26 July 2019 This document replaces: IPC-0001-008 v1 Laundering and Safe Handling of Clothing Procedure Lead: Name Title Angela Ridley Head of IPC and Physical Health and Back Care (Nursing) Members of working party: Name Title Angela Ridley Emma Rolfe Andrea Brodie Senior Nurse IPC and Physical Health and Back Care Lead Nurse IPC and Physical Healthcare Information Mapping and Policy Development Manager This document has been agreed and accepted by: (Director) Name Elizabeth Moody Title Director of Nursing and Governance This document was approved by: An equality analysis was completed on this document on: Date Name of committee/group 26 July 2016 Infection Prevention and Control Committee 11 August 2016 Change record Version Date Amendment details Status 1 7 Mar 2013 Withdrawn 2 26 July 2016 Full revision Withdrawn 2.1 19 Apr 2017 Minor amendments (shown in red) Published Ref IPC-0001-008 v2 Page 12 of 12 Ratified date: 27 July 2016