The COVID 19 pandemic has presented healthcare institutions with many new challenges.
One of the serious problems is ensuring sanitary and hygienic standards of cleanliness in conditions of full load and intensive work. The issue of cleanliness of medical clothing and bed linen occupies one of the first places. How to properly approach the organization of a hospital laundry?
The main document is the Order of the Ministry of Health No. 29 "On approval of the Instructions for the collection, sorting, transportation, storage, disinfection and washing of linen in healthcare institutions." Based on this document, we will tell you about the basic rules for organizing the work of a hospital laundry.
The laundry room of a multidisciplinary medical institution (hospital with 100 beds or more) must have the following rooms:
- room for receiving and sorting linen
- washing shop
- Drying and ironing shop
- room for repair, packaging and storage of linen
- linen delivery room
- storage room for detergents and disinfectants
- staff living quarters (shower, toilet, etc.).
The selection of equipment is based on the “Classification of Linen”.
Classification of linen. The degree of soiling of the laundry in accordance with the instructions
| Purity level | Description of linen | Commentary |
|---|---|---|
| 1st degree - uncontaminated laundry | New products that have no visible dirt or damage, come from a warehouse and have not been used | In practice it is almost never encountered |
| II degree - slightly contaminated | Textile products with general contamination, special clothing for food service departments, administrative staff | In fact, this is only special clothing for non-medical personnel. |
| III degree - moderately polluted | Textiles with general soiling with minor traces of blood, urine, vomit, feces, drugs | The bulk of linen from therapeutic hospitals |
| IV degree - significantly contaminated | Textiles with significant contamination with blood and other biological secretions. Significantly contaminated linen includes newborn diapers and linen from infectious diseases departments | The bulk of linen from surgical hospitals |
Separation of hospital linen flows
Clause 6 of the Order notes: "In order to ensure sanitary and hygienic and anti-epidemic regimes and prevent the spread of nosocomial infections through linen from maternity hospitals, anti-tuberculosis institutions, gynecological, surgical, dermatovenereological and infectious hospitals (dispensaries), linen from these institutions must be washed in specially designated laundries, separately from other hospitals and departments. If it is not possible to have a special laundry, such linen is washed separately from linen from other departments. In this case, linen is received in a separate room, where a division into a "dirty" and "clean" section is provided."
Use of conventional industrial washing machines and barrier-type machines in laundries
Point 7 explains which laundry equipment must be installed in hospital laundries. “All linen, special clothing and personal protective equipment from infectious diseases departments, as well as linen contaminated with biological secretions from somatic and surgical departments, clinical diagnostic laboratories, pathology departments and the forensic medical examination bureau are disinfected and washed in walk-through washing machines, which have two windows - a window for loading (dirty) and a window for unloading (clean). Processing of other textile products can be carried out in conventional washing machines, that is, in non-passable type equipment. »
Unfortunately, due to limited government funding, point 7 is practically not implemented - a barrier washing machine is three times more expensive than a regular industrial one. Hospitals are limited to using separate washing machines for the above-mentioned type of laundry, and also allocate separate rooms for such machines (the best option in the absence of a barrier machine, but rare).
Technological flows of dirty and clean linen should not intersect
Collection of linen, transportation, storage and delivery must meet the requirements of the Instructions. In order to avoid the transfer of infection and improve the organization of further washing of linen, all containers for collecting linen should be marked indicating the department of the establishment and the degree of contamination of the linen. Appropriate color codes or inscriptions should be used for marking.
| Purity level | Description of linen | Marking |
|---|---|---|
| 1st degree - slightly contaminated | Linen that cannot be washed at the same time as bed linen (e.g. aprons, work clothes, napkins, etc.) | White color |
| II degree - slightly contaminated | Textile products with general contamination, special clothing for food service departments, administrative staff | Green color |
| III degree - moderately polluted | Textiles with general contamination with minor traces of blood, urine, vomit, feces , medicines | Yellow |
| IV degree - significantly polluted | Textiles with significant contamination of blood and other biological secretions. Significantly contaminated linen includes diapers for newborns and linen from infectious disease departments | Red color with additional inscription "ATTENTION! Infected underwear" |
Let's give an example of how you can equip a washing shop for a general hospital (according to the above Order No. 29 of the Ministry of Health)
| Linen group according to the technological line | Amount of linen per day (maximum) | Washing machine |
|---|---|---|
| Linen from the maternity ward | 100 kg | Barrier, 16 kg, 1 pc. |
| Linen of the 4th degree of contamination | 350 kg | Barrier, 27 kg, 2 pcs. |
| Linen of the 3rd degree of contamination | 160 kg | Barrier, 24 kg, 1 pc. |
| Linen from newborn and infant departments | 50 kg | Industrial 10 kg, 1 pc. |
| Linen from infectious compartments | 100 kg | Barrier, 16 kg, 1 pc. |
| Special clothing for non-medical workers | 50 kg | Industrial 10 kg, 1 pc. |
If funding does not allow the installation of barrier machines, then separate premises and separate industrial-type machines are allocated for washing in the maternity, infectious diseases and purulent-surgical departments.
