INF ECTION P R EVENTION


to prevent escape of any liquid droplets. A Government memorandum5


states it


is essential that clinical laundry areas are enclosed away from treatment and public areas and must only be accessed by those using the facilities for laundry reprocessing. This minimises the risk of introducing contamination to laundered items. Similarly, best practice would involve the use of separate trolleys or baskets for clean and dirty laundry, colour coded accordingly. Assume that lab coats or scrubs going into laundry are contaminated and treat them accordingly, wearing appropriate PPE when loading washing machines. Remember to keep the exterior control panels and surfaces of washing machines and dryers clean and disinfected, paying attention to the underside of handles which may be missed in a general surface clean.


Different makes and models of industrial washing machine operate in different ways and it is important that operatives are familiar with the correct wash programmes to provide the desired cleaning results, for example a standard wash or thermal disinfection. Models designed specifically for healthcare environments generally have multiple disinfection programmes so operatives should learn how to select the appropriate cycle for the type of load. Contact your product manufacturer for


further advice on programmes and operation. It is recommended that machines are checked prior to purchase to ensure they have the specified programming ability to meet the disinfection standards required, as set out in a Department of Health notice.6 The memorandum also states that “purpose- designed washers are preferable to domestic types” and that temperature sensors and monitoring equipment are installed. If installing a new machine which will be laundering items which may be contaminated with infectious agents, ensure vent pipes and drains are routed so that steam or water drainage does not cause potential cross contamination. With manual dosing, you will need to ensure there is sufficient detergent in the machine to perform the selected cycle appropriately. Under-dosing can result in an ineffective wash. If your machine uses automatic dosing of detergent, there is no need to worry about this as the washer will draw on the amount of liquid detergent it requires to clean the weight of laundry in the machine to the desired parameters. A protein check kit can be used on scrubs or garments which may have been in contact with bodily fluids, to ensure all potential contaminants have been removed successfully during the wash.


Garments are at increased risk of attracting airborne contamination when they are wet. For this reason, it is desirable to keep your dryer next to or stacked on top of your washing


machine, providing the minimum distance to transfer wet laundry into the dryer. If your machines are next to each other, arrange your machines so that both doors open away from each other, so you have easy access to transfer the wet laundry into the dryer.


If it is not possible to have your machines in the same room, ensure they are transferred as quickly as possible and are not left to stand in between. For this same reason, do not unload washed items if the dryer is not available to load them right away. When transporting clean linen this should be moved and stored to avoid recontamination “as far as is reasonably practicable”.7


It is advisable to establish the appropriate


drying programme and time for your standard laundry loads as, when wearing gloves, it can be difficult to adequately check if laundry is dry at the end of a cycle. By experimenting beforehand, you can avoid the risk of unloading laundry which is not properly dry, which may then be worn by staff in a compromised state.


Staff members should be aware of the


necessary hygiene routines to adopt when donning scrubs or protective wear at the start of a shift to avoid introducing contaminants to the clean items.


All reprocessing machinery should be


serviced regularly to ensure it is performing correctly. An IQOQ at installation will set out and confirm a number of parameters to be sure that the equipment is working as it is intended. Effective machinery combined with careful and cautious reprocessing practices will ensure the safest possible clinical environment for patients and healthcare staff alike.


CSJ


References 1 https://www.bbc.co.uk/news/uk-england- nottinghamshire-37115958


2 https://www.thelancet.com/journals/lanmic/article/ 68 l WWW.CLINICALSERVICESJOURNAL.COM MAY 2021 About the author


Nadine Bellamy-Thomas is the national account manager medical and decontamination, Miele GB. Nadine has worked for Miele GB in its UK laboratory and dental division for four years. Her role involves working with clients to provide bespoke solutions for their reprocessing needs and advising on product suitability as well as giving practical installation guidance.


PIIS2666-5247(20)30009-4/fulltext


3 https://www.who.int/water_sanitation_health/ medicalwaste/148to158.pdf


4 https://www.nytimes.com/2020/05/29/health/ coronavirus-transmission-dose.html


5 Health Technical Memorandum 01-04: Decontamination of linen for health and social care Management and provision


6 Health Technical Memorandum 01-04: Decontamination of linen for health and social care Engineering, equipment and validation


7 Health Technical Memorandum 01-04: Decontamination of linen for health and social care Management and provision


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