EN 14065 (Textiles - Reprocessed Textiles in Laundries - Biocontamination Control System)
Infection Control - Contamination Containment
The risks of bio-contamination and the preventative role of the laundry process.
are many potential sources of microbiological contamination in
hospitals and the reality is that, as all processes within hospitals
are interrelated, bacteria are easily spread and can infect a whole
hospital unless stringent controls are in place
instance, bacteria can initially be transferred to the patient through
contact with the contaminated sheet. It is transferred to the nurse
while attending to this patient.
the bacteria on the patient, on the patient's clothing and in the
patient's bed linen continue to grow, the hospital employee, having
failed to wash his/her hands, inadvertently transfers the bacteria to
their own uniform, to the patient's chart, to general equipment in use
on the ward, as well as to other in-patients with whom the employee is
the meantime, the next employee may well have washed their hands after
dealing with the first patient, but not after handling that patient's
records. The transfer of the bacteria by this employee quickly occurs
as the ward rounds are completed. Clinical teams may well cover 15-20
wards in a single ward round. Nurses will often cover a number of
wards, for instance, and patients themselves may also be transferred
from one ward to another during the course of a single day.
the end of the day, it is likely that the initial bacterium will have
multiplied and spread to a number of wards and even beyond the hospital
itself as visitors enter and leave the hospital. Additionally, staff
may wear potentially infected uniforms as they return home at the end
of their shift.
Laundry's Importance in Containment
importance of laundry is often underestimated when we think about
patient care, despite indications that good hospital laundry practice
can reduce bio-contamination levels. Hospital acquired infections (HAI)
affect the health and recovery of tens of thousands of patients and can
cause death. No one in the healthcare environment can afford to ignore
the role of laundry in the fight against lethal bacteria.
to an article in the New York Times, the super spreader of the recent
SARS epidemic in Taiwan was a laundry worker at one of Taipei's largest
gowns, uniforms, towels, cleaning tools (mops, cloths) and ward
furnishings are crucial 'touch points' for anyone working in or
visiting a hospital. They are a gateway for infections: if properly
controlled, the laundry process can limit the spread of bacteria; if
not, the handling of the laundered item will ensure swift
bio-contamination throughout the hospital.
the warm, damp environment of a laundry room can make it an excellent
breeding ground for bacteria, rather than a decontamination zone.
New EU Standard
managers and healthcare workers can no longer ignore the issue of
hospital laundry and its role in HAIs. A new EU standard has come into
force that seeks, for the first time, to address the role that laundry
management plays in spreading lethal bacteria and potentially fatal
suggest that the improved application of existing knowledge and
realistic infection control policies, for instance in Europe, would
reduce the current UK rate of HAIs by 15 per cent (National Audit
Office, 2000). The adoption of a wide range of straightforward hygiene
practices, from hand washing in between dealing with patients to
improved laundry management, such as, the rigorous separation of clean
and dirty linen, can contribute to this reduction.
New EU Standard
laundry practice is, of course, based around appropriate washing
techniques that ensure decontamination of materials. However, this is
just part of the picture: it also needs to ensure that linen is stored,
sorted and transported correctly and that opportunities for
recontamination are minimised.
aspects of good practice require a more technical knowledge of hygiene,
such as how to keep the soiled linen area at a lower air pressure than
the clean linen area (negative air pressure). However, many elements
are straightforward common sense; for example, the need for scrupulous
separation of clean and dirty materials. Distressingly, there are
plenty of examples of hospital laundries continuing to make these basic
expert from the Pasteur Institute in France recently said that: 'In
hospitals, bio-contamination is particularly undesirable as there are
so many high-risk areas, such as operating theatres, and
immuno-compromised patients. Monitoring the microbiological quality of
the environment helps hospitals to understand the effectiveness of
their infection control procedures, and to ensure that appropriate
measures are in place.'
Bargibant of Electrolux Laundry Systems, who has been working with the
Pasteur Institute in France for the last ten years to instigate best
laundry practice to reduce bio-contamination, says: 'Keeping down the
level of bio-contamination in hospitals is a constant battle. Changing
how you manage hospital laundry is not a miracle solution to HAIs, but
if we don't even apply the most commonsense rules of hygiene to laundry
processes then we don't stand a chance of beating the bugs.
The ELS Approach
Electrolux Laundry Systems' (ELS) approach is based on the 'Risk
Analysis and Biocontamination Control System' (RABC), an emerging
European Standard (EN 14065) for controlling the microbiological
quality of laundered textiles.
This model is focused around:
Audit. Understanding the laundry process in its entirety so that the
right processes can be identified for the demands of a specific
Equipment. Reviewing whether the right equipment is in place, from
specialist barrier washers for decontaminating infected materials that
are used in sensitive patient environments to straightforward tools
such as closed trolleys for transporting clean linen.
Control. Constant reviews of the microbiological quality of the linen,
levels of decontamination and so on. Electrolux works with specialist
laboratories, such as the Pasteur Institute, to verify hygiene