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AIIMS case studies: Creating infection barriers in hospital laundries

Healthcare linen in India has often been looked at as a vector for hospital-acquired infections. Causes include improper handling of soiled linen, incorrect usage of washing chemicals & washing cycles, inappropriate packing and storage of washed and ironed linen, and lack of SOPs. Anshul Gupta, Founder & CEO, Quick Clean, pinpoints the wrongs and rights in healthcare linen laundries.

Many private hospitals outsource their laundry services offsite to unorganized dhobis.  Lately, professional laundries too are being engaged for washing healthcare linen. However, infected linen could lead to spread of infection even beyond the hospital premises. Hence, it is always better to have the laundry set up on-site.

One solution that is working well for the hospital linen is barrier laundries. Quick Clean along with Electrolux Professional has been conducting educational workshops on barrier laundry for the health ministry, government health departments, AIIMS hospitals and different bodies over the last seven years. It has also been educating doctors and medical superintendents on how to develop on-site laundry processes and infrastructure for handling linen on-site.

Hospitals now are opting for barrier laundries. AIIMS Nagpur is one of the first hospitals to install a barrier laundry. The new AIIMS hospitals coming up are embracing the trend. Laundries at AIIMS Kalyani and Kolkata are now operational too.

In order to ensure linen hygiene standards, controls and processes have been set up, right from collection of dirty linen to delivery of clean linen to wards. An eight-step process has to be followed for linen hygiene.

In a hospital, whiteness of the linen holds lesser importance than hygienically clean linen. This can be achieved through right processes, right disinfection in the wash cycle, right temperature, right chemicals, and also proper validation at every stage. This can only happen when the linen is handled professionally by an organisation or team that understands the importance of hygiene, and the process to disinfect and deliver hygienically clean linen to hospitals.

In the past, during a survey of hospitals, we found that the nurses were carrying their uniforms for washing at their homes. These nurses – who were exposed to infected patients – were carrying infections home. The washing at home lacked the right detergents and the washing cycles as per required standards.

Following workshops by Quick Clean, the linen and uniforms of the nurses are being processed on-site.  We are urging other hospitals too to ensure nurses’ uniforms are not sent to their homes but are being sent along with the other linen of the hospital to be processed.

Case Study: AIIMS Kalyani

The on-site laundry set up at AIIMS Kalyani processes over 300 pieces of bed linen. Ajay Malik, Superintendent explained: “The hospital is at 70% occupancy with 150 beds, but we get other laundry from OPDs, OTs and from guest houses.

“The linen is khadi in nature and some of it comes from Quick Clean. There are two kinds of linen which we separate at source — infected linen and non-blood stained linen.

“The hospital laundry has an institutional design which is suitable and adequate for managing everything. It has been laid out nicely by Quick Clean’s team with some minor rectifications.

“We have our own team managing along with the Quick Clean team. Our faculty and nurses work side by side to coordinate the work. Every month, we perform a microbiological test to ensure the sterility of the linen and to see if the linen meets our standards.

“It is critical to have an on-site laundry to keep track of the work being carried out. We can conduct surprise checks at any time and regular auditing. In an outsourced laundry, we have no idea of what they are doing. We had outsourced our laundry but wanted to keep our standards high. Although the outsourced vendor was doing a good job for us, we wanted our very own in-house laundry set up.

“We have a professionally run laundry now. Quick Clean has had a good impact on our hospital staff as well. So much so that other departments are observing how the Quick Clean team works and are improving their work as well. The importance of linen segregation has been recognised by the other departments.”

Case Study: AIIMS Nagpur

The 580-bed AIIMS hospital at Nagpur is expanding to 960 beds. According to Vijay Nayak, Deputy Director, AIIMS Nagpur: “For any hospital, it is of utmost importance to maintain hygiene levels and keep linen infection-free. The linen should be washed scientifically with proper chemical treatment and ensured that infection is not be transferred at any level.

“In our 7,000 sq ft laundry, Quick Clean has set up the barrier washer which is exactly what we require. Barrier washers have the dirty linen enter on one side and clean linen coming out from the other side; there is no interaction between both sides. Even the staff do not interact or shake hands or use the same washrooms.

“This is possible only with an on-site laundry. In outsourced laundries, there is no supervision, no checks on the chemicals or quality of water being used for washing.

“With an in-house laundry, everything is automated. We can check and supervise the work being carried out as per our norms.

“We store three times the laundry linen on-site. In the outsourced model, if there is any delay and the linen is not returned in time or if the cycle fails, it can create a huge problem.”

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