Hospital and Nursing Home Laundry: Infection Control Basics
Soiled linen in hospitals and nursing homes can carry large numbers of microorganisms, yet the risk of disease from properly handled laundry is very low. The difference is in the handling. These are the basics, based on guidance that the U.S. Centers for Medicare & Medicaid Services issued together with the CDC.
Handling soiled linen
- Standard precautions apply to all used linen: no special sorting or extra labeling is needed for linen from isolation rooms.
- Bag it where it is used. Do not sort or pre-rinse soiled linen in patient or resident areas.
- Minimum agitation. Do not shake linen; shaking spreads contamination to air, surfaces and people.
- Leak-resistant bags for linen soiled with blood or body fluids. Double-bag only if the outside of the bag is visibly contaminated or wet.
- Protect staff: gloves, gowns and hand-washing facilities in the laundry area.
Washing methods that are accepted
- Hot water: washing at more than 160°F (71°C) for 25 minutes.
- Low temperature: 71–77°F (22–25°C) with appropriate chemicals. A chlorine bleach rinse is an option but is not required for every item, because modern detergents can produce hygienically clean linen.
- Ozone laundry systems: CMS and CDC consider them acceptable when used according to the manufacturer’s instructions. See our guide to ozone laundry systems.
Whatever the method, follow the instructions of the detergent and chemical supplier for dosing, rinse aids and other additives.
Machine and room care
- Leave washing machine doors open when not in use so drums dry out; warm, wet machines grow microbes.
- Never leave damp linen in machines overnight.
- Keep clean and soiled linen physically separated, with clean linen covered during transport.
- Maintain air flow from the clean side toward the soiled side of the laundry.
Why ozone is attractive here
Healthcare laundries wash large volumes every day and pay heavily for hot water. Ozone systems let many loads be washed in cold water while still meeting accepted infection control practice, which is why they are common in nursing homes and assisted living facilities. The room must still be ventilated and monitored so ozone in the air stays below the OSHA limit of 0.10 ppm.