A Question for the IP: How is Your Facility Laundering its Linens Today?

By John Scherberger BS, FAHE, CHESP, REH

A couple of years ago, there was a report in the news that during 2008 and 2009 five children died at a Louisiana children’s hospital from an infection passed to them through their hospital linens. To follow up on this tragedy, a reporter wanted to know if there had been any changes made in how the hospital laundered its linens. The reporter posed this question to the hospital’s associate medical director of patient safety and quality. According to her account, the reporter asked the medical director who was the hospital’s current launderer. First, the medical director responded that he didn’t think it was pertinent, and then he said he didn’t know. And he said he didn’t know a second time when asked the same question at a subsequent news conference. Keep in mind: This is the hospital’s director of patient safety and quality.

At the time, a colleague of mine expressed his bemusement at this ill-omened lack of awareness of critically important matters, and asked the question: “When it comes to healthcare-associated infections (HAIs) and patient safety, who in the hospital hierarchy needs to know what and when?”

Similarly, since she/he is the expert on preventing and controlling the spread of infectious diseases, we ask of the infection preventionist (IP): Do you know how your facility is laundering its linens today? We fear your answer is, no.

My organization, the Healthcare Laundry Accreditation Council (HLAC), recently had the privilege of exhibiting at the annual conference of the Association for Professionals in Infection Control and Epidemiology (APIC). At the APIC event, we learned that possibly all too often IPs are not making the connection to the fact that improperly laundered healthcare textiles (HCTs) can pose as a vehicle for the transfer of pathogens to patients and hospital workers. We learned of the need for increased awareness among IPs that, to minimize potential infection risks, a program that ensures hygienically clean and safe HCTs must be part of their infection prevention strategy. I say this because we want the IP to realize that the tragedy in Louisiana is not the only occurrence of patient deaths due to contaminated HCTs. We view this as an opportunity for HLAC to partner with IPs to provide this kind of education.

HLAC is a nonprofit organization that inspects and accredits laundries that process reusable HCTs for hospitals, nursing homes and other healthcare facilities. HLAC is in its 10th year of inspecting and accrediting healthcare laundries of all shapes and sizes. We heard recently from the general manager of one of these laundries, who told us: “Thank you for the opportunity to go through the accreditation process for the fourth time. Each time we have succeeded in achieving our accreditation and each time we have grown in knowledge and experience. We find HLAC accreditation an excellent way to provide our healthcare partners with the reassurance they need that the products they receive are sanitary, safe and of consistent quality designed to reach the highest of standards.”

It’s because of these sorts of testimonials that HLAC accreditation increasingly is becoming a requirement of informed hospitals for a healthcare laundry to be considered as an authorized vendor. HLAC-accredited laundries process HCTs based on the highest standards for patient safety and infection prevention. These HLAC Accreditation Standards have been developed based on federal regulations and guidelines as well as best industry practices. Like many other accreditation organizations, including the Joint Commission, HLAC accreditation is for three years. It means that a laundry meets standards that have been documented, published and professionally recognized. Standards documents are available for review and to download at HLAC’s website, www.hlacnet.org.

HLAC accreditation affirms that a laundry organization that processes healthcare linens has successfully passed an inspection of the following: its facility, policies and procedures, training programs, and its relationship with its healthcare customers. The inspection process is fee-based, takes one day and is conducted by HLAC inspectors who are independent contractors who have a wide range of experience and expertise in the healthcare laundry industry. Also, unannounced inspections can be conducted at any time if there is a legitimate concern that HLAC Standards aren’t being followed.

HLAC does not have membership. Instead, it has a 12-person board of directors whose participants serve on a voluntary basis. The board of directors comprises an independent and highly experienced group of professionals – this includes or has included IPs, commercial laundry operators, association executives, co-op and on-premise laundry operators, hospital environmental services directors, university medical staff and representatives of federal government organizations.
As noted in the aforementioned testimonial, the principal benefit of HLAC accreditation to healthcare customers – that is, those individuals in the hospital hierarchy who need to know – is the knowledge and confidence that their textile provider is meeting the highest standards in the industry for processing healthcare textiles, including strict adherence to federal government regulations and guidelines. The customer can expect a consistent and smooth flow of clean textiles; and, ultimately, the knowledge of safety for their employees and the end user – the patient.

Specific to HCTs and perhaps of most relevance to the IP, a new report highlighting evidence-based strategies notes that proper laundering and handling are important in achieving and maintaining the hygienically clean quality of healthcare fabrics and textiles delivered to the point of care. This study is notably comprehensive – it is based on findings and recommendations from peer-reviewed studies, as well as current standards and guidelines to inhibit serious contamination during the processing of HCTs, many of which are applicable to HLAC standards. The study also makes the case that healthcare epidemiologists would benefit from gaining familiarity with HCT laundering, facility policies and procedures for management of hygienically clean HCTs – and it encourages on-site inspections of the healthcare laundry by hospital staff to ensure safe and effective service.

Note: Our HLAC Standards are available in checklist form for IPs to take along to the healthcare laundry inspection. For more information, contact HLAC toll-free at (855) 277-4522 or visit www.hlacnet.org.

John Scherberger, BS, FAHE, CHESP, REH, is board president of the Healthcare Laundry Accreditation Council.

References:
 1. “A Deadly Fungus and Questions at a Hospital,” by Ian Urbina and Shari Fink, The New York Times, April 28, 2014.
 2.  “How is your hospital laundering its linens? We tried to find out,” by Rebecca Catalanello, The Times-Picayune, May 19, 2014.
 3. “With HAIs, Who in Hospital Hierarchy Needs to Know What and When?” by George Clarke, LinkedIn.
  4. “Hospital Outbreak of Pulmonary and Cutaneous Zygomycosis Due to Contaminated Linen Items from Substandard Laundry,” Oxford Journals, Dec. 1, 2015.
  5. “Bacillus cereus bacteremia outbreak due to contaminated hospital linens,” U.S. National Library of Medicine National Institutes of Health, February 2011.
  6. “Healthcare Laundry and Textiles in the United States: Review and Commentary on Contemporary Infection Prevention Issues,” by Lynne M. Sehulster, Infection Control and Hospital Epidemiology, September 2015.