Healthcare & Hospital Hygiene ●●● Cleaning up confusion about laundry
The Department of Health’s new standard for the decontamination of linen in the healthcare sector needs de- mystifying to be workable. John Middleton, MD of commercial laundry specialist JTM Service, reports.
Managers in the healthcare laundry sector are concerned about how to best imple- ment the new Choice Framework for Local Policy and Procedures (CFPP 01-04). I think that the new guidelines are so detailed that laundry workers will struggle to match duty of care and best practice with the commer- cial reality of diminished budgets. People responsible for policy in hospital and healthcare laundry rooms are wading through the four manuals produced by the Department of Health in a bid to under- stand what they mean in practice. There has been a great deal of media coverage about the emergence of new strains of su- perbugs, and new detergents have been de- veloped to respond to these where low temperature washing is required. However, the practice of washing linen at 65ºC for 10 minutes or 71ºC for three minutes to achieve thermal disinfection remains un- changed.
Amalgamating previous versions of laun- dry guidance for the sector, the revised guidelines focus on two levels of attain- ment: Essential Quality Requirements (EQR) is a term that encompasses all exist- ing statutory and regulatory requirements. This is the minimum requirement. Moving on from this, additional items of Best Prac- tice (BP) may be required as relevant to the level of risk identified. I suggest five steps to approaching the
new CFPP 01-04 standard: • Carry out a risk assessment and review in-house procedures to ensure they comply with Essential Quality Requirements as a minimum. Consider Best Practice recom- mendations and decide how best to deal with serious infections or linen from an un- known source. The laundry process should be designed to minimise the risk of con- tamination of lines, so ensure you have dis- tinct and separate areas for clean and soiled linen.
• Write a manual for laundry operatives including the safe operation of all equip- ment and guidance on ensuring the correct programme is followed in line with linen type and level of soiling. Ensure that exter- nal providers have a full understanding of what is expected from them, eg fabric bags are no longer permitted for infectious linen. It is a good idea to keep a register of manu- facturers washing requirements for all linen in use throughout the organisation. • Decide on the level of soiling categories and devise a workable solution. Linen should be divided into two main categories: standard process, where the source of the soiling is known and there is no risk of se- rious infection; and enhanced process, where triggers have identified a serious risk, or the linen is from an unknown source. Consider the wash requirements of the linen and select the relevant process. • Decide on how your equipment per-
formance will be continuously monitored to maintain disinfection requirements. This may be by periodic validation of the ma- chine controls or by third party validation equipment fitted to the machine to record data on every wash to maintain a full audit trail. Make the necessary provisions with
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manufacturers or independent contractors. • Set up your own internal audit process to periodically assess the performance of the process and make adjustments or im- prove training as necessary. JTM Service has over 30 years’ experi-
ence in the laundry industry .
www.jtmservice.co.uk
Validation: an example of a temperature curve and associated reporting.
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