Attachment 5 - Laundry Infection Prevention Must Haves.docx
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HT9408-22-Q-0004
Attachment 5
Infection Prevention & Control - Laundry Requirements and Regulatory Considerations
| Must Haves |
| Regulatory Requirements |
Guidelines for Environmental Infection Control in Health-Care Facilities Recommendations of CDC 2003 Updated: July 2019 (Note 1) APIC Text 4th Edition Healthcare Textile Services These do not align with the must haves in columns 1 & 2
Laundry Facilities and Equipment
| Maintain the receiving area for contaminated textiles at negative pressure compared with the clean areas of the laundry in accordance with AIA construction standards in effect during the time of facility construction. Category IC |
| A functional barrier by negative air pressure in soiled areas |
| Emergency eyewash/shower equipment must be available with unobstructed access. Regulatory /OSHA |
| · Warning signs about the presence of contaminated textiles and the need to follow Universal Precautions must be posted in work areas. (Also an OSHA requirement) |
| Safety features (e.g., emergency lighting, signage, fire alarms, door accessibility and egress, safety perimeter for robotics, equipment guards) must be evident and operational. OSHA |
| · The textile areas must be free of vermin, devoid of lint, and without obvious moisture contamination. |
| Working surfaces that become contaminated with blood or OPIM must be decontaminated, cleaned, and disinfected with EPA-registered hospital disinfectants labeled tuberculocidal or registered disinfectants on the EPA Lists D and/or E. OSHA |
| · Cardboard must not be used as shelf liner material. |
| · A written Regulated Medical Waste management plan OSHA |
| Working surfaces must be kept clean of visible soil, dust, and lint. |
| Compliance with regulations as they pertain to air, water, and chemicals management (City/County/State) |
Evidence of waste water and/or air quality permit compliance (City/County/State)
Compliance with hazardous chemical regulations (City/County/State)
| Ensure that laundry areas have handwashing facilities and products and appropriate PPE available for workers. Category IC |
| · Hand hygiene resources must be available in or around all work areas and in personnel support areas. |
· Documentation of personnel health and hygiene and use of PPE and attire OSHA
| Use and maintain laundry equipment according to manufacturers’ instructions. Category II |
| · Documentation on types of laundry equipment, equipment installation, operation, safety, preventative maintenance, and repairs |
| An occupational safety and health program based on the OSHA Bloodborne Pathogen Standard and Universal Precautions OSHA |
Do not leave damp textiles or fabrics in machines overnight. Category II
· An Exposure Control Plan (ECP) OSHA
· A hepatitis B vaccination program OSHA
· A standing process for post-exposure management for blood and/or OPIM OSHA
· A hazardous materials (e.g., non-biological, chemical, radiological) safety plan and policy OSHA
· Training and educational programs must include Bloodborne Pathogens Exposure Control Training, Hazardous Substance Contaminated Textiles training, Department of Transportation (DOT) regulations training OSHA
Routine Handling of Contaminated Laundry
Handle contaminated textiles and fabrics with minimum agitation to avoid contamination of air, surfaces, and persons. Category IC (OSHA: 29 CFR 1910.1030 § d.4.iv)
Soiled textiles shall be collected and handled only as necessary to complete the defined tasks, and in such a way as to minimize microbial contamination of the air and the personnel handling the textiles. Soiled textiles must not be sorted or rinsed in patient-care areas.
· The laundry provider must maintain functional separation of clean from soiled textiles in carts and/or vehicles at all times during the collection and transportation of soiled textiles.
· Standard precautions must be observed while moving, loading, and unloading soiled textiles.
Laundry Process
| If hot-water laundry cycles are used, wash with detergent in water ≥160°F (≥71°C) for ≥25 minutes. Category IC |
| The wash cycle shall comply with all applicable state and local requirements for healthcare textile processing. |
| Follow fabric-care instructions and special laundering requirements for items used in the facility. Category II |
| Each classification shall have established standards for the following factors: Cycle time: Pre-wash, wash, rinse, and final rinse times; water levels/usage (total water usage and/or water levels); temperature (wash cycle, bleach cycle and rinse cycle temperatures); and chemical usage (chemical types and usage levels for each step in the wash process) |
| Choose chemicals suitable for low-temperature washing at proper use concentration if low-temperature (<160°F [<71°C]) laundry cycles are used. Category II |
| Clean healthcare textiles shall be extracted or dried in a manner that preserves the integrity of the textile merchandise, minimizes microbial growth after washing, and prepares the textiles for efficient ironing or folding |
Finishing
The finishing process of ironing or folding textiles shall ensure that the merchandise is maintained in the same clean state that it emerged from washing
The ironing or folding procedures shall meet the needs and expectations of the user. If any textiles become soiled in this process, they shall be rewashed
· Ironing equipment shall be maintained in good operating condition so that it adequately irons, dries, and folds the textiles without excessive heat, pressure, or mechanical damage. The equipment shall maintain a temperature of at least 300 degrees on the ironer chests.
· Dry folding equipment shall be in good operating condition.
Packaging and Storing
| Package, transport, and store clean textiles and fabrics by methods that will ensure their cleanliness and protect them from dust and soil during interfacility loading, transport, and unloading. Category II |
| · Packaging and storage of healthcare merchandise shall maintain the textiles in a clean state for delivery to the customer. |
· The textiles may be wrapped into fluid-resistant bundles, or placed bundled but unwrapped into fluid-resistant covered carts or hampers. The wrapping material may be plastic or other suitable material, and shall be securely closed during transport to the customer.
· During packaging, textiles shall be handled as little as possible to prevent soiling or contamination.
· If unwrapped merchandise is placed into carts or hampers and covered, the container shall remain covered at all times until delivered to the user's textiles storage room or other designated location in the healthcare facility. If the cart does not have a solid bottom, it must be lined with heavy plastic or impervious paper before placing clean textiles inside.
· Bundled and wrapped textiles may be stored in open racks in the laundry, on the trucks, or at the user's facility, provided the integrity of bundled and wrapped textiles is not compromised.
· If any textiles become soiled during packaging and storage, they shall be reprocessed in accordance with previously stated processing guidelines.
· Unwrapped clean textiles may be stored in designated rooms.
Delivery of Cleaned Healthcare Textiles
· Maintain functional separation of clean from soiled textiles during transportation by bagging soiled textiles in fluid-resistant containers and anchoring soiled textiles in the vehicle so that they do not spill from their containers.
· Clean and soiled textiles may be transported in the same vehicle if functional separation is maintained using physical barriers, and/or space separation sufficient to protect clean textiles from contact with soiled textiles.
· Clean and soiled textiles shall not be stored in the same container.
· If a cart is used to transport clean textiles, the textiles shall be wrapped inside the cart, or if unwrapped, the cart shall be lined with plastic or heavy paper and covered. Carts must be maintained in good working order.
· Carts, containers, covers, and liners used to collect or transport soiled textiles must be properly cleaned and disinfected after the cart is emptied and before any next use, whether to transport clean textiles or soiled textiles.
· The interior of the transport vehicle shall be cleaned on a regular basis or when visibly soiled.
· Vehicles must have waterless hand cleaner, PPE, and spill kits on board.
Note 1: CDC Rating Categories Recommendations are rated according to the following categories:
• Category IC. Required by state or federal regulation, or representing an established association standard. (Note: Abbreviations for governing agencies and regulatory citations are listed, where appropriate. Recommendations from regulations adopted at state levels are also noted. Recommendations from AIA guidelines cite the appropriate sections of the standard).
• Category II. Suggested for implementation and supported by suggestive clinical or epidemiologic studies, or a theoretical rationale.
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