Linen Managment services in hospital ppt 2024.pptx

linen management is importance in health care , how the quality of hospital can represent in society

1. Lecture on policy and procedures of laundry and linen management in hospital services Prepared By Dr.Anjalatchi Muthukumaran Professor Cum Vice Principal And Nursing Supt. Era College Of Nursing , Elmch , Era University Lucknow 226003

2. Term used in chapter Soiled Linen : Linen visibly contaminated by blood, body fluids, secretions and excretions are “Soiled / contaminated / dirty / fouled”. Used Linen : All other used linen is termed “used ”. Clean linen : without dirty, after clean, iron, and folded to kept in rack followed by delivery services to the customer .

3. Brochure for online lecture about linen policy

4. Content of lecture LAUNDRY SERVICES AND LINEN MANAGEMENT Number of Linen Sets LINEN BEDDING CLASSIFICATION OF LINEN LABELING OF LINEN LINEN COLLECTION AND SEGREGATION TRANSPORTATION OF LINEN RECEIVING IN THE LAUNDRY RECEIVING IN THE LAUNDRY WASHING HYDRO EXTRACTING AND DRYING REPAIR OF LINEN (IF NECESSARY ) CALENDERING AND IRONING DELIVERY OF CLEAN LINEN DELIVERY OF CLEAN LINEN

5. Hospital support service Support Services In The Hospital Play A Major Role In Ensuring That They Provide The Defined Services In An Efficient Manner And Also Enable The Other Staff Of The Hospital To Carry On The Activities Which Are Required For Patient Care Delivery. An Engaged And Integrated Support Service Team Has Significant Effect On Hospital Services Which Allows Patients To Heal Quicker, Promotes A Safer Environment, And Improves The Satisfaction Of Staff, Patients, And Families. The Contributions Made By Support Service Personnel In Today’s Hospitals Have Become A Crucial Component To The Organization's Success. The Major Support Services Areas Covered Under These Guidelines Include: • Laundry Services & Linen Management • Water Sanitation • Kitchen Services • Security Services • Outsourced Services Management

6. LAUNDRY SERVICES AND LINEN MANAGEMENT The Provision Of Clean Linen Is A Fundamental Requirement For Patient Care. Incorrect Procedures For Handling Or Processing Of Linen Can Present An Infection Risk Both To Staff And Patients Who Subsequently Use It. Hence, Correct Linen Management Is Important To Prevent HAI And Ensure A Better Hygienic Hospital Environment. The Term ‘Hospital Linen’ Includes All Textiles Used In The Hospital Including Mattresses, Pillow Covers, Blankets, Bed Sheets, Towels, Screens, Curtains, Doctors Coats, Theatre Clothes And Table Clothes. The Hospital Receives All These Materials From Different Areas Like OT, Wards, Outpatient Departments And Office Areas.

7. Type of laundry services

8. Classification of hospital linen Classification of Hospital  Linen - Classification based on use of linen: a ) General Purpose linen : This includes curtains, drapes, table clothes and similar items commonly used in all parts of the hospital . This is the linen which is not used for patient care . b) Patient linen : This consists of patient clothing such as patient pyjamas, shirts, gown, coats etc. c ) Ward Linen: This consists of patient-bed clothing such as bed sheets, pillow covers , blankets used by the patient. d ) OT, Labour  room, Procedure room linen: This includes items such as pyjamas, kurtas , gowns, coats , shirts etc. worn by surgeons, anaesthetists, OT personnel and also surgical gowns, caps, masks, trolley covers, OT towels etc. required in OT, labour room and procedure room. Classification based on colour of linen: a) Ward Linen: This linen should be white in colour b ) Operation Theatre Linen : This should be green in colour including doctor’s gown c ) Patient Linen: This should be blue in colour

9. CLASSIFICATION OF LINEN Dirty Linen Dirty Linen Is Used Linen, But Not Visibly Soiled With Blood Or Blood Tinged Body Secretions. Soiled Linen Oiled Linen Is Known, Or Potentially, Infected/Infested Linen. All Linen Which Is Contaminated With Excreta, Blood Or Body Fluids Or Contaminated Linen From A Patient Who Is Known Or Clinically Suspected, To Be Infected With Diseases Like Salmonella, Hepatitis A, B Or C, Open Pulmonary Tuberculosis, HIV Etc .

10. Number of Linen Sets ideal to be Hospitals Need To Ensure That They Have At Least Four Sets Of Linen Per Day, Even Though Six Sets Are Preferable. Classification Of Six Sets Of Linen Needed In Hospitals Is As Follows: • One Already In Use (On Bed) • One Ready To Use (In Sub Store) • One In Transit-route To Laundry Or To The Ward • One In Washing Cycle In Laundry • Two In Stock (In Central Store) Thus, In An Ideal Situation, For A 100-bedded Hospital, 600 Bed Sheets Are Needed . Hospitals Need To Maintain The Linen Stock Register For Available Linen In The Central Store Or With Laundry In-charge Of The Hospital.

11. Basic principles of LINEN management The Basic Principles Of Linen Management Are As Follows: Place Used Linen In Appropriate Bags At The Point Of Generation • Contain Linen Soiled With Body Substances Or Other Fluids Within Suitable Impermeable Bags And Close The Bags Securely For Transportation To Avoid Any Spills Or Drips Of Blood, Body Fluids, Secretions Or Excretions • Do Not Rinse Or Sort Linen In Patient Care Areas (Sort In Appropriate Areas) • Handle All Linen With Minimum Agitation To Avoid Aerosolisation Of Pathogenic Micro-organisms • Separate Clean From Soiled Linen And Transport/Store Separately • Wash Used Linen (Sheets, Cotton Blankets) In Hot Water (70°C To 80°C) And Detergent, Rinse And Dry Preferably In A Dryer Or In The Sun • Autoclave Linen Before Being Supplied To The Operating Rooms/Theatres • Wash Woolen Blankets In Warm Water And Dry In The Sun, In Dryers At Cool Temperatures Or Dry-clean

12. Type of linen used in hospital services

13. Importance of linen in hospitals

14. Source of linen available

15. Handling of linen

16. Design and plan requirements

17. Work flow of linen management

18. LABELING OF LINEN All Linen Being Used In Hospitals Needs To Be Labelled For Identification And Traceability. Proper Labelling Of The Linen Also Helps In Proper Inventory Management. The Label Of The Linen Includes The Following Minimum Details: • Name Of The Hospital (XYZ) • Name Of The Department Or Number Of Ward ( ICU/OBS/WARD) • Type Of Linen Like Bed Sheets (BS), Patient Gown (PG), Pillow Cover (PC) • Number Of Linen I.E. 1, 2, 3… • Doctors Coat Labelled With Doctor’s Name For Example, Bed Sheets Used In Icu Of Hospital Can Be Labelled As: Xyz/ Icu / Bs /1, Similarly Bed Sheet In General Ward 1 Can Be Labelled As: Xyz/Gw1/ Bs /06

19. LINEN COLLECTION AND SEGREGATION The Hospital Should Have Fixed Schedule For The Collection Of Linen From Different Areas Of The Hospital All The Patient Linen Including Bed Sheets, Patient Gowns Needs To Be Changed Daily All The Linen Of Critical Areas Like OT And ICU Etc. Need To Be Changed Daily The Staff Linen Needs To Be Changed On Weekly Basis It Is Strongly Recommended To Change All The Linen Used In The Hospital When Visibly Dirty Or Are Soiled While Collecting Linen, Care Should Be Taken To Ensure All Sharps Or Patient Equipment Is Removed Staff Should Wear Appropriate PPE Like Heavy Duty Gloves, Apron And Mask During Linen Handling. Any Skin Lesions On Hands Should Be Covered Hand Hygiene Should Be Practiced After Linen Handling Linen Needs To Be Collected In Bags And Trolleys And Should Not Be Placed On The Floor Or Any Other Surfaces

20. CONTINUE To Minimize Aero Soilsation Of Any Organisms Contaminating Linen, Linen Should Not Be Rinsed, Shaken Or Sorted In The Clinical Area. The Personnel Should Keep his/her Hands Away From Face While Handling Linen • The Collected Linen Needs To Be Stored At A Designated Place I.E. In Dirty Utility Of The Area Of Generation. • The Attendant/Sister In-charge Of The Area Needs To Update The Daily Transaction Register Every Time Linen Is Collected From The Area. The Transaction Register Should Include The Details Of The Number Of Different Types Of Linen Items Collected From The Particular Area. A Separate Register Has To Be Maintained In Different Areas For The Same.

21. TRANSPORTATION OF LINEN Linen Collected From Different Areas Of The Hospital Needs To Be Transported In The Covered Trolleys To The Laundry. • Dirty And Soiled Linen Needs To Be Transported In Separate Trolleys • A Dedicated Trolley For Transportation Of Linen Needs To Be Used And Trolleys Used For Waste Collection Or Any Other Purpose Should Not Be Used For Transportation Of Linen • During Transportation It Is To Be Ensured That The Bags Used For Collection Of Linen Are Properly Tied . Linen bag to be fille d 2/3 laundry bag. • In Case Of Any Spillage Of The Soiled Linen During Transport, The Linen Needs To Be Securely Placed In The Transportation Trolley And Cleaning Of The Surface Is Undertaken As Per The Spill Management Protocol Of The Hospital .

22. RECEIVING linen IN LAUNDRY The Person Responsible For Receiving Linen In The Laundry Needs To Enter The Details Of The Linen In The Receiving And Distribution Register At The Laundry. The Details Include Type And Quantity Of Linen Received, The Department From Where Linen Is Received, Time And Date Of Receiving. Records Are Necessary To Ensure Quality Assurance Of Linen And Laundry Management In The Hospital

23. Hospital Linen Stain removal procedure

24. Hospital linen management process

25. Infrastructure and workflow cycle

26. Barrier system working flow

27. Continued

28. WASHING of hospital linen process Washing By Hand STEP 1: Wash Heavily Soiled/Infected Linen Separately From Non-soiled Linen STEP 2: Wash The Entire Item In Water With Liquid Soap To Remove All Soilage , Even If Not Visible REMEMBER : Pre-soak In Soap, Water And Bleach ONLY If Linen Is Soiled- Use Warm Water If Available Add Bleach (For Example, 30–60 Ml [About 2–3 Tablespoons], Of A 5%chlorine Solution) To Aid Cleaning And Bactericidal Action Add Sour (A Mild Acid Agent) To Prevent Yellowing Of Linen, If Desirable Step-3: Check The Item For Cleanliness. Rewash If It Is Dirty Or Stained STEP 4: Rinse The Item With Clean Water

29. HYDRO EXTRACTING AND DRYING All The Linen Is Checked For Any Damage, Wear And Tear • In Case Of Any Damage Like Minor Hole Or Tear Observed, It Should Be Sent For Repair And Mending • If The Linen Is Severely Damaged And Cannot Be Repaired, The Same Can Be Discarded Or Condemned As Per The Hospital Condemnation Policy, By The Laundry Supervisor

30. Sorting the linen a. Sorting Of Linen Before Washing Shall Be Done, In The Laundry Area Only. B. Sorting Shall Be Performed Carefully As Soiled Linen From The Operating Room Or Other Procedure Areas Infrequently Contain Sharps (Scalpels, Sharp-tipped Scissors, Hypodermic And Suture Needles And Sharp-tipped Towel Clips). C. Infectious Linen Must Not Be Sorted And Loaded In To A Washing Machine Directly. D. Wear PPES While Handling Soiled Linen, From Patients’ Rooms As There Maybe Soiled Dressings, Blood-stained Cloths Or Cloths Wet With Other Body Fluids .

31.   Care of linen  materials 1 . linen materials should be stored in dry places 2. using large amount of washing soda and bleaching agent can damage the linen. 3. rinse the fabrics properly to avoid deposition of detergents 4. the materials should be dried out properly otherwise it generate terrible odour and also the lifetime of the materials will be shortened. 5. should not use bleaching powder directly on the fabric. 6. remove deposited stains immediately from the fabric. 7. should not mix infected linen with others. 8. should not overload washing or squeezing machines.

32. CALENDERING AND IRONING Bed Sheets And Other Heavy Linen Needs To Be Calendared With Mechanized Calendaring Machines Installed At The Hospital If The Hospital Does Not Have The Facility Of Calendaring Machines, The Linen Needs To Be Ironed Using Flat Work Iron And Is Folded Properly. DELIVERY OF CLEAN LINEN The processed linen is transported in clean covered trolley to the central store . It is to be ensured that the storage of clean linen before distribution is separate from dirty linen From the central store the clean linen is issued to respective departments based on the indent generated from the departments From the central store the linen is distributed to respective departments in the clean trolleys Record of issued linen needs to be updated in the central store room while the respective departments need to update the transaction register with the details of linen received in the department .

33. Clean linen to be press, iron and folded and distribution to ward

34. BEDDING Mattresses And Pillows With Plastic Covers Should Be Wiped Over With Disinfectant Such As 70% Alcohol Or 1% Chlorine Solutions. • Mattresses And Pillow Cover Without Plastic Covers Should Be Washed With Water And Detergent And Left For Air Drying After Discharge Of Every Patient, Or On Weekly Basis If Occupied By Same Patient • Blankets May Be Dry Cleaned Or Hand Washed. It Can Be Done By Soaking For 15 Minutes In Lukewarm Water. Then Soap Suds Are Squeezed Through The Blanket And Then Rinsed In Cold Water At Least Twice. The Blanket Should Not Be Twisted Or Wrung. It Should Be Dried By Spreading On Clean Surface

35. After disinfectant exposed with sun light

36. Responsibilities of team

37. RESPONSIBILITY OF LINEN MANAGEMENT Change Of Linen - Staff Nurse/Ward Attendant Sorting And Storing Of Used Linen - Ward Attendant/Housekeeping Staff Disinfection Of Soiled/Infected Linen - Housekeeping/Laundry Staff Collection Of Used/Soiled Linen - Laundry Staff Counting Of Collected Linen - Laundry Staff/Nursing In-charge Transporting Dirty Linen - Laundry Staff Washing, Drying And Ironing - Laundry Staff Receipt Of Washed Linen In Departments - Nursing In-charge s Storage And Issue Of Washed Linen - Nurse In-charge

38. Table 23: Do’s and don’ts for Linen Management

39. Detergent requirement per 100 kg linen

40. Preparation of Chlorine solution using Hypochlorite Solution Concentration of commercially available hypochlorite solution Required chlorine Concentration To prepare 1000 ml Solution in ml Add water in ml 5% 2 400 600 1 200 800 0.50% 100 900 10% 0.50% 50 950 1 100 900 2 200 800

41. Preparation of Chlorine Solution using Bleaching powder Solution PREPARATION OF DILUTE SOLUTIONS OF BLEACHING POWDER Strength of SBP (Strength of beaching powder) Volume of water Desired concentration Bleaching powder in grams per litre 20% 1 litre 0.50% 25 1% 50 2% 200 5% 250 10% 500 25% 1 litre 0.50% 25 1% 40 2% 80 5% 200 10 400 30% 1 litre 0.50% 17 1% 33 2% 67 5% 167 10 333

42. LINEN changing POLICY GUIDELINES: 7.1 hospital linen or clothing: 7.1.1 shall be changed and laundered between patients change . 7.1.2 shall be changed daily for patients nursed in isolation or 7.1.3 when they are soiled or fouled shall be changed. 7.2 pillows and mattresses: impervious cover of these items shall be routinely wiped clean between patients change with hot water and detergent . if surface contamination with blood or body fluids occurs clean with hypochlorite 0.5% in a detergent solution. they shall not go into the laundry. they shall be cleaned at the point of use or department. the damaged item shall be discarded as clinical waste. 7.3 all cloth items (e.g., surgical drapes, gowns, wrappers) used during a procedure shall be considered infectious and they shall be laundered even if there is no visible contamination. 7.4 housekeeping and laundry personnel shall wear PPE (aprons, gloves and eye wear) when collecting, handling, transporting, sorting and washing soiled linen . 7.5 disposable linen shall be used for patients with/ suspected suffering from anthrax, small pox and viral hemorrhagic fever. 7.6 if hospital linen has been used in these circumstances, it shall be treated as clinical waste. The functions of the laundry services : Collecting soiled linen from various places. Sorting the linen and processing (Cleaning) them Inspecting and repairing or replacing damaged materials. Distributing clean linen to the respective user departments. Maintaining different types of registers .

43. Quality of monitoring linen management

44. PPE for housekeeping staff and Laundry staffs: Gloves: Thick utility or heavy-duty house hold gloves to minimize the risk of accidental injury from a needle-stick or other sharp object, including broken glass. Apron : Made of plastic or rubber. Closed shoes Protective eye wear Usage of PPE: Handling disinfectant solutions. Collecting and handling soiled linen Transporting soiled linen Sorting soiled linen Hand washing soiled linen Loading automatic washers

45. RECORDS List Of Files And Registers To Be Maintained For Linen Management In The Hospital: • Linen Stock Register At The Central Store • Area Wise Daily Transaction Register • Laundry And Linen Receiving Register And Distribution Register At The Laundry Condemn policy register

46. List of records and register

47. Sample of format for linen management

48. Linen auditing process

49. Hospital linen loss process .  loss of linen “nearly  90% of all linen used in u.s. hospitals does not reach its useful life costing the healthcare industry more than $840 million annually”. healthcare laundry accreditation council ( hlac ) quotes that: 3 ways that  linen loss occurs: 1. the visitor or patient ‘accidentally’ leaves the hospital with linens after vigilantly packing it into their bags with haste. 2. EMS staff taking too much, or linens getting lost during patient transfers. 3. staff hoarding linen in rooms or misusing the linen for other purposes, such as cleaning liquid off the floor. hoarding is an abnormal behavior characterized by excessive acquisition and an inability or unwillingness to discard large quantities of objects that cover the living areas of the home and cause significant distress.

50.   How to Prevent  Linen Loss • Linen automation system: Amount of linen taken out of the linen cart is tracked. Support services receive real-time updates of linen levels. • Control the access to the linen. Only allow access to authorized staff through their existing ID scan badges. • Linen Audit: Taking a physical inventory of all linens you have on hand regularly . • Educate your employees. A good portion of linen loss is due to employees tossing soiled linens into the trash. • Keeping a record of when the employee received their uniforms and how many uniforms were supplied. • Inspect patients’, visitors’ and employees’ bags as they exit the facility.

51. Conclusion A n efficient and  effective linen and laundry services can enhance patient experience and reduce the risk of cross contamination. laundry and its products should preserve the patients’ dignity, promote the patients’ care and be appropriate to patient group, gender, clinical status, religion and beliefs. quality inspectors may wish to understand how the laundry process impacts above and design a framework to identify necessary quality requirements within the organization

52. Linen inventory checklist

53. Soil linen collection status per day sample

54. Clean linen distribution list per day

55. THANK YOU