Safe Disposal Of Contaminated Linens: A Comprehensive Guide

Contaminated linens are a common byproduct of healthcare and social care, and their proper disposal is essential to prevent the spread of harmful microorganisms and ensure the safety of both patients and staff. Used linens in healthcare settings can harbour dangerous pathogens, such as MRSA and VRE, which can survive on linens for several days and pose a significant risk of cross-contamination. Therefore, it is crucial to follow strict protocols when handling, transporting, and disposing of contaminated linens to minimise the risk of infection and ensure compliance with health and safety regulations.

Wash hands after handling contaminated linens

It is important to wash your hands after handling contaminated linens, as this is a key step in preventing the spread of disease. Contaminated linens are a breeding ground for bacteria and viruses, which can be transmitted to others. The Centers for Disease Control and Prevention (CDC) and leading nursing textbooks such as Fundamentals of Nursing caution that healthcare workers should always wash their hands after handling contaminated linens to avoid the contamination of air, surfaces, and persons.

The proper protocol for disposing of contaminated linens involves a series of steps to ensure safety and prevent the spread of microorganisms. Firstly, it is important to wear personal protective equipment (PPE) when handling contaminated linens, as they can transfer pathogens to skin and clothing. Gloves are especially important, and reusable gloves are preferable to disposable ones as they offer better protection and are less likely to tear. Masks and protective eyewear are generally not necessary, according to guidelines from the National Association of Institutional Linen Management (NAILM).

After putting on the appropriate PPE, contaminated linens should be carefully placed into a portable linen hamper or tucked into a pillowcase at the end of the bed. It is important to never shake the linens in the air, as this can disseminate microorganisms. Linens from one patient's bed should never be placed on another patient's bed, chair, or couch, even momentarily. Once the linens are safely in the hamper or pillowcase, they can be gathered up for disposal in the linen hamper or linen chute.

The linens should then be washed as soon as possible, separately from other items. Clothing can be decontaminated in a 40°C-50°C wash followed by tumble-drying or hot ironing, while bedding and towels should be washed in hot water to ensure bacteria are killed. Chlorine bleach can be added to the wash cycle for an extra margin of safety. After washing, the linens should be stored separately from contaminated linens to prevent cross-contamination.

Use PPE when handling contaminated linens

When handling contaminated linens, it is crucial to prioritize the safety of those involved by adhering to proper protocols and donning the appropriate personal protective equipment (PPE). The use of PPE serves as a critical barrier against the transmission of harmful microorganisms, safeguarding both the individual handling the linens and the wider environment. Here are some detailed instructions and considerations for employing PPE when dealing with contaminated linens:

The first step in preparing to handle contaminated linens is to don the appropriate PPE. This typically includes gloves, which act as a protective barrier for your skin. Reusable gloves are recommended over disposable ones due to their superior durability and protection against tearing during the rigorous process of sorting linens. Gowns are also essential to protect your clothing from potential contamination. It is important to remember that the goal is to prevent skin and clothing exposure to contaminated linens, so ensure that the PPE covers any potential points of contact.

In certain situations, additional PPE may be necessary. For instance, if there is a risk of exposure to splashing body fluids, it is advisable to wear protective eyewear to shield your eyes. Furthermore, if there is a high likelihood of airborne dispersal of pathogens, a mask may be warranted to safeguard your respiratory system. However, it is important to follow the guidelines provided by your specific workplace or regulatory body, as they will outline the required PPE for different scenarios.

Once you have donned the appropriate PPE, you can proceed with handling the contaminated linens. Remember to exercise caution and follow the standard precautions for linen handling. Avoid shaking or agitating the linens excessively, as this can lead to the dissemination of microorganisms. Instead, carefully place the linens into a designated laundry receptacle, preferably as close to the point of use as possible. If the linens are heavily soiled, consider using a water-soluble bag inside a plastic bag for added security.

After placing the contaminated linens in the appropriate receptacle, secure the bag and, if applicable, tag it with relevant information such as the ward, care area, and date. This helps with organization and ensures the linens are handled according to specific requirements. It is also important to store the bagged linens in a designated, safe, and lockable area while awaiting uplift or laundry services.

Lastly, remember to pay attention to hand hygiene. Wash your hands thoroughly after removing your PPE and ensure the designated handwashing area is equipped with a designated sink and the necessary supplies. Proper handwashing is a vital step in breaking the chain of infection and preventing the spread of microorganisms.

Bag contaminated linens at the location of use

When it comes to removing contaminated linens, it is important to exercise caution to prevent the creation of airborne dispersal of pathogens and to avoid cross-contamination. Healthcare linens are known to harbour several microorganisms, including MRSA and VRE, which can survive on linens for days and become a source of cross-contamination. Therefore, it is crucial to handle contaminated linens properly to ensure the safety of both healthcare workers and patients.

• Ensure that a laundry receptacle is easily accessible and located as close as possible to the point of use for immediate linen deposit. This could be a portable linen hamper or a pillowcase at the end of the bed.
• Place the contaminated linen directly into the laundry receptacle without shaking or agitating it excessively. This is because shaking soiled linen can disseminate secretions, excretions, and microorganisms, increasing the risk of airborne contamination.
• Avoid placing the soiled linen on any other surfaces, such as the floor, a locker, or a tabletop, before bagging it.
• If the linen is infectious or heavily soiled, place it into a water-soluble or alginate bag, secure it, and then place it into a plastic bag before putting it into the laundry receptacle.
• Wash your hands thoroughly after handling contaminated linens, and avoid touching your clothing or uniform during the process.
• Make sure the collection bag is of sufficient quality to contain the wet/soiled linens and prevent leakage during handling and transportation. The bag should be impervious and durable to contain the linens effectively.
• Do not overfill the laundry receptacle or bag. Leave enough space to secure the bag and prevent spillage during transportation.
• Tag the bag or receptacle with relevant information, such as the ward/care area and the date. This helps with tracking and ensures timely uplift schedules.
• Store the bagged linens in a designated, safe, and lockable area while awaiting uplift. Ensure that there is no buildup of linen receptacles, and follow acceptable uplift schedules.
• Do not re-handle the bagged linens once they have been secured in the bag or receptacle. This helps minimise the risk of contamination and exposure.
• If possible, use reusable gloves when handling contaminated linens, as they provide better protection than disposable gloves due to their durability and reduced risk of tearing.
• Maintain vigilant handwashing practices, ensuring proper friction and duration, to protect against the transmission of disease from contaminated linens.
• Adhere to any local or facility-specific guidelines and procedures for managing contaminated linens. These guidelines may include specific requirements or precautions for your particular setting.

Wash contaminated linens separately

When it comes to contaminated linens, it is essential to understand the risks associated with them and the proper protocols for handling and disposing of them. Healthcare linens, in particular, can harbour various microorganisms, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE). These pathogens can survive on linens for days and pose a significant risk of cross-contamination.

To prevent the spread of such infections, it is imperative to wash contaminated linens separately from other items. This practice is crucial in preventing the transfer of harmful microorganisms to other items and reducing the risk of cross-contamination.

• Use Personal Protective Equipment (PPE): When handling contaminated linens, always wear PPE, such as gloves and a face mask, to protect yourself from potential exposure to pathogens.
• Sort and Segregate: Before washing, ensure that contaminated linens are sorted and separated from other laundry. Keep them in a designated area or container, clearly labelled as contaminated laundry.
• Washing Instructions: Wash contaminated linens in a hot wash setting, using detergent and bleach if possible. A temperature range of 40°C to 50°C is recommended for effectively killing bacteria.
• Double Washing: In some cases, such as when dealing with chemotherapy contamination, it is advised to wash contaminated linens twice, even if they are washed separately from other laundry. This helps ensure that all traces of contamination are removed.
• Drying and Ironing: After washing, tumble dry the linens or iron them with a hot iron. These steps help ensure that any remaining bacteria are eliminated.
• Handling Clean Linens: Once the linens have been decontaminated, store them separately from any contaminated linens to prevent cross-contamination. Always follow agreed-upon protocols and guidelines, such as the dignity code, essence of care, and compassion.

By following these guidelines, you can effectively reduce the risk of cross-contamination and help maintain a safe environment for patients and staff. Remember to consult your line manager or refer to local guidelines if you have any questions or concerns about handling contaminated linens.

Store clean linens correctly

Clean linens should be stored in a cool, dark, and well-ventilated area away from sunlight. This is true for both 100% cotton and cotton blends. The storage area should be secured and protected from insects and rodents, and it should be kept clean and disinfected to maintain hygiene standards.

When storing clean linens, it is important to cover them to prevent dust or other contaminants from soiling them. If using a trolley without doors, use a cover. If stored in a cupboard, ensure the door is kept closed when not in use. Regularly clean the storage area with a good-quality disinfectant to maintain a clean environment. No soiled linens should be placed in the linen cupboard, and food and beverages should not be consumed near the linens to avoid contamination.

Label storage areas to ensure all linens have a designated place and to make it easier to manage inventory and replace linens. This will also help to reduce handling and maintain hygiene standards. Stack linens in a standardised rotation pattern, no more than two piles deep, to maximise stock rotation and ensure regular turnover.

Before storing linens, they should be laundered according to the following instructions: use a full/normal wash cycle, target a pH of 6.5 for the product after washing, and do not use softeners or starch as these can cause yellowing over time. Completely dry the linens and let them sit for 6-8 hours before final packaging. The room should be dry and cool (50-80º F) to allow the cotton moisture content to equilibrate to the proper level.

When boxing linens for storage, use cardboard and line the box with a discarded sheet to prevent staining. Stack linens on wire shelves and cover with a sheet in an appropriate storage area. Plastic is not recommended for linen storage as it does not breathe and is prone to condensation, which can cause yellowing.

Frequently asked questions