Operations Related to Textile Management

Operations Related to Textile Management / en Tue, 22 Oct 2024 23:37:14 -0500 Mon, 16 Nov 20 22:08:20 -0600 Principles of Effective Linen Management 2021 /education-events/principles-effective-linen-management This facilitated online course is for health care environmental services and textile care professionals. The course provides an introduction and overview of key linen management issues such as linen utilization, abuse and loss management, infection prevention in textiles (including a discussion focused on the science of antimicrobial textiles), effective laundry management options and operations, OSHA standards, and HLAC accreditation standards. Mon, 16 Nov 2020 22:08:20 -0600 Operations Related to Textile Management Maintaining Hygienically Clean Health Care Textiles Within a Health Care Facility /maintaining-hygienically-clean-health-care-textiles-within-health-care-facility <h1>Maintaining Hygienically Clean Health Care Textiles Within a Health Care Facility</h1> <h3>By John F. Scherberger</h3> November 5th, 2018&nbsp;|&nbsp;Formats:&nbsp;Technical Paper |&nbsp;Content Areas:&nbsp;Administration&nbsp;|&nbsp;Tags:&nbsp;Environmental hygiene and sanitation, Infection Prevention and Epidemiology, Laundry and Textiles, Linen <hr /> Health Care textiles are a crucial component in the care and treatment of patients if positive outcomes are to be realized. The absence of guidance from regulatory organizations pertaining to the handling, internal transportation, and storage of hygienically clean textiles (HCTs) within the confines of health care facilities (HCFs) brings into question the hygienic integrity of such textiles. The lack of guidance and best practice standards in health care facilities brings into question the confidence needed to assure that a chain of infection prevention practice is in place in health care facilities. This document addresses the shortcomings and provides suggested direction and support. Keywords: Textiles, hygienically clean, infection prevention, shortcomings &nbsp; <div class="col-md-8"> <div> <h4 class="text-align-center">Access Today</h4> If you do not have member access, complete the form below to view this resource. If you are a member, login and access the technical paper through Key Resources on this page. &nbsp; MktoForms2.loadForm("//sponsors.aha.org", "710-ZLL-651", 2941); </div> </div> &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; Mon, 05 Nov 2018 12:16:44 -0600 Operations Related to Textile Management Press Release: Ken Tyler Receives VA 2018 Lifetime Achievement Award /press-release-ken-tyler-receives-va-2018-lifetime-achievement-award September 2018&nbsp;|&nbsp;Formats:&nbsp;News Release <hr /> Encompass Group, LLC Announces Ken Tyler, VP Government Operations, Awarded Department of Veterans Affairs 2018 Lifetime Achievement Award. McDonough, GA–(September 2018) – Ken Tyler, VP Government Operations, Encompass Group, LLC was awarded the Veterans Affairs 2018 Lifetime Achievement Award at the VA National Environmental Programs Service Conference held August 2018 in Orlando, Florida. “We are pleased to announce this recognition of Ken’s lifetime of dedication to the care of our nation’s veterans,” said John Wood, CEO of Encompass. “He is an integral part of Encompass Group’s government operations. Ken has served his country for most of his life. Prior to joining us, he served at the Department of Veterans Affairs, the Department of the Navy, and is a decorated U.S. Marine Corps combat veteran.” “I am very honored to be recognized by the VA with this award,” Tyler said. “It has been an honor to aid our country’s veterans, and to serve our nation.” The Lifetime Achievement Award was presented, “In recognition of Ken Tyler’s superb leadership and professionalism resulting in far reaching improvements in the effectiveness and quality of healthcare delivery to veterans nationwide.” Ken Tyler served as Chief, Textile Care Division at VA Headquarters, Washington DC from 1977 to 2000. He is best known for his development of the VA Laundry Modernization Program where he managed the modernization of 54 facilities (valued at $175 million) and the new construction of 15 new VA laundries (valued at $140 million). He was very active in management of the VA Laundry Consolidation Program in which VA consolidated 73 existing facilities into just 41. Some of Ken Tyler’s most notable accomplishments include: Managing the EMS product standardization program and uniform committee, serving as Acting EPS Director from 1989-1991, and his development of the Under Secretary for Health Field Laundry Advisory and establishment of the VA laundry/quality assurance programs. Additionally, he is a graduate of the VA Leadership Program and a recipient of three Hammer Awards from the Vice President of the United States, three Scissor Awards from the Secretary of Veterans Affairs, and two Department of Energy Conservation Awards. “There’s no better exemplar of our commitment to helping our customers deliver better care than Ken Tyler,” said John Wood, Encompass Group CEO. “We are so proud of him and his service.” 91�� Encompass Group Encompass is one of the world’s leading manufacturers and marketers of reusable textiles, professional apparel, and disposable and single use medical products. Encompass believes that every patient, resident, caregiver, and family member should feel safe and comfortable in today’s healthcare environments. The way Encompass enhances the healthcare experience is by developing innovative products that are reliably delivered and cost effective for all providers. The markets we serve include Acute Care, Long-Term Care/Senior Care, Retail Health Care Apparel, Hospitality, and Government Operations. For more information, please visit www.encompassgroup.net, email info@encompassgroup.net, or call (800) 284-4540.&nbsp; Mon, 24 Sep 2018 10:39:44 -0500 Operations Related to Textile Management Hospital Beds /hospital-beds December 6th, 2017&nbsp;|&nbsp;Formats:&nbsp;Guideline&nbsp;|&nbsp;Content Areas:&nbsp;Environmental Sanitation Operations, Textile Management Operations&nbsp;|&nbsp;Tags:&nbsp;Beds, Laundry and Textiles, Linen <hr /> <header role="heading"> <section data-block-plugin-id="entity_view:node" id="block-entityviewcontent-14"> Between January 1, 1985 and January 1, 2013, FDA received 901 incidents of patients caught, trapped, entangled, or strangled in hospital beds. The reports included 531 deaths, 151 nonfatal injuries, and 220 cases where staff needed to intervene to prevent injuries. Most patients were frail, elderly or confused. </section> </header> The efforts of the FDA and the Hospital Bed Safety Workgroup have culminated in FDA's release of&nbsp;<a href="https://www.fda.gov/media/71460/download" target="">Hospital Bed System Dimensional and Assessment Guidance to Reduce Entrapment</a>. This guidance provides recommendations for manufacturers of new hospital beds and for facilities with existing beds (including hospitals, nursing homes, and private residences). Healthcare facilities developing comprehensive bed safety programs should consider: <ul> <li>following the Clinical Guidance for the Assessment and Implementation of Bed Rails to assess an individual patient's needs when using a side rail; and</li> <li>consulting with the hospital bed manufacturer and their facilities’ risk managers.</li> </ul> The HBSW has developed a&nbsp;<a href="https://www.fda.gov/medical-devices/hospital-beds/hbsw-hospital-bed-safety-entrapment-kit-ordering-instructions">Bed Safety Entrapment Kit</a>&nbsp;containing information and tools that can be used to assess the risk of entrapment in hospital beds. Additional information about the kit is also provided in the FDA Guidance. &nbsp; <a href="https://www.fda.gov/medical-devices/general-hospital-devices-and-supplies/hospital-beds">https://www.fda.gov/medical-devices/general-hospital-devices-and-supplies/hospital-beds</a> Wed, 06 Dec 2017 15:27:33 -0600 Operations Related to Textile Management Covers for Hospital Bed Mattresses: Learn How to Keep Them Safe /covers-hospital-bed-mattresses-learn-how-keep-them-safe December 6th, 2017&nbsp;|&nbsp;Formats:&nbsp;Guideline&nbsp;|&nbsp;Content Areas:&nbsp;Environmental Sanitation Operations, Textile Management Operations&nbsp;|&nbsp;Tags:&nbsp;Beds, Environmental hygiene and Sanitation, Laundry and Textiles, Linen, Policies <hr /> Hospital beds refer to a variety of medical devices that are classified as beds. FDA regulations classify hospital beds as Class I and Class II devices. These devices are used for patients in acute care, long-term care, or home care settings. A hospital bed system encompasses the bed frame and its components, including the bed side rails, head and foot board, the mattress, and any accessories added to the bed, such a detachable mattress cover. A hospital bed mattress cover provides outer protection to a mattress by preventing blood and other body fluids from entering the inside (inner core) of the mattress. Such covers may be coated with or contain an antimicrobial solution that kills germs (viruses or bacteria) or prevents bacterial growth. There are multiple terms used to describe hospital bed mattress covers: water-resistant (keeps liquid away from the material), water-proof (prevents liquid from entering inside the material), or water-repellent (keeps liquid away from the material and prevents liquid from entering inside the material). Covers are usually detachable from the mattress or the mattress lining, meaning that they can be removed or replaced. <h4>Safety Concerns</h4> Over time, hospital bed mattress covers can wear out and allow blood and body fluids to penetrate and get trapped inside mattresses. If blood or body fluids from one patient penetrate and get absorbed in a mattress, the fluids can leak out the next time the mattress is used. Coming into contact with these fluids poses a risk of infection to patients using the bed. The FDA issued a&nbsp;<a href="https://wayback.archive-it.org/7993/20170722215739/https:/www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm348016.htm" target="_blank">safety communication</a>&nbsp;in 2013 alerting health care providers, health care facility staff, and caregivers to these safety concerns. From 2011 through 2016, the FDA has received over 700 reports of a hospital bed mattress cover failing to prevent blood or body fluids from leaking into the mattress. <h4>Recommendations</h4> These recommendations are based on&nbsp;<a href="https://www.cdc.gov/infectioncontrol/guidelines/environmental/index.html" target="_blank">guidelines</a>&nbsp;for environmental infection control in health care facilities issued by the&nbsp;<a href="https://www.cdc.gov/" target="_blank">Centers for Disease Control and Prevention</a>&nbsp;(CDC). They are intended to help health care providers, health care facility staff, and caregivers ensure hospital bed mattress covers are safe for use in health care settings. <h5> Develop an Inspection Plan</h5> <ul> <li>Create an inspection plan for all hospital bed mattresses and mattress covers in your facility.</li> <li>Check the manufacturers’ guidelines for an expected life time on the hospital bed mattress and mattress covers and follow any additional recommendations listed there.</li> <li>Contact the mattress cover manufacturer for any additional questions not covered here.</li> </ul> <h5>Inspect</h5> <ul> <li>Regularly check each hospital bed mattress cover for any visible signs of damage or wear such as cuts, tears, cracks, pinholes, snags, or stains.</li> <li>Routinely remove the hospital bed mattress cover and check its inside surface. Once the mattress cover is removed, inspect the mattress for wet spots, staining, or signs of damage or wear. Check all sides and the bottom of the mattress.</li> <li>Be aware that it may be difficult to identify damaged or soiled mattresses without removing the mattress covers first. Mattress covers tend to be dark in color, making it hard to see what lies underneath.</li> </ul> <h5>Remove and Replace</h5> <ul> <li>Remove any damaged, worn, or visibly stained hospital bed mattress according to the health care facility’s procedures and manufacturer’s instructions.</li> <li>Immediately replace any hospital bed mattress cover with visible signs of stains, damage or wear to reduce the risk of infection to patients.</li> </ul> <h5>Maintain</h5> <ul> <li>Clean and disinfect undamaged hospital bed mattress covers according to the manufacturer’s guidelines.</li> <li>DO NOT stick needles into a hospital bed mattress through the mattress cover.</li> </ul> <h4>Hospital Bed Mattresses Covers Safety Poster</h4> The FDA has developed a poster addressing key safety aspects about hospital bed mattress covers, including the recommendations listed above. This poster is available for free download and can be used as a safety reminder about hospital bed mattress covers in health care settings. &nbsp; <a href="https://www.fda.gov/medical-devices/hospital-beds/covers-hospital-bed-mattresses-learn-how-keep-them-safe">https://www.fda.gov/medical-devices/hospital-beds/covers-hospital-bed-mattresses-learn-how-keep-them-safe</a> Wed, 06 Dec 2017 15:16:50 -0600 Operations Related to Textile Management Health Care Furniture Design - Guidelines for Cleanability /health-care-furniture-design-guidelines-cleanability April 11, 2017&nbsp;|&nbsp;Formats:&nbsp;Guideline&nbsp;|&nbsp;Content Areas:&nbsp;Planning, Design, and Construction, Textile Management Operations&nbsp;|&nbsp;Tags:Design and Construction, Laundry and Textiles<hr><h1>1. Scope</h1>The purpose of this Guideline is to provide guidance to furniture manufacturers and healthcare professionals in understanding typical cleaners, disinfectants, cleaning methods, and performance of furniture when exposed to these cleaners and disinfectants. It is the intent of this guideline to bring the recommended manufacturers' standards in line with existing practices and typically used cleaners. This guideline offers standard test methodologies and specific performance recommendations to which manufacturers can test; and to which users may evaluate relative product performance. This guideline also provides product design considerations that support effective cleanability of healthcare furniture products.This Guideline applies to seating, tables, carts, storage and other furniture products as used in healthcare patient care. This Guideline also applies to furniture intended for use outside of patient care areas in healthcare environments as furniture is often used interchangeably between patient care and non-patient care areas. These guidelines are not necessarily applicable to health care areas such as offices or administrative areas.This Guideline does not apply to healthcare products considered to be ‘equipment’ (patient lifts, beds, transfer benches, wheelchairs and other products covered by IEC 60601).This guideline does not purport to address the effectiveness (i.e., the level of disinfection) of any cleaning agent or cleaning process. Guidance is available in the reference section for specific cleaning and disinfection protocols recommended by the 91��. Only the effect on the subject material (textile, plastic, finish, etc.) is assessed by the methodologies within this guideline.It is the intent of this guideline to ensure compatibility of the health care setting’s cleaning and disinfecting agents with the items and surfaces to be cleaned. Materials and finishes must be compatible with hospital-grade detergents, cleaners and disinfectants for best results.Authors of this Guideline consider furniture to be ‘Non-critical’ per the Spaulding Classification System (See Definitions). Non-critical items such as furniture come in contact with intact skin but not mucous membranes.The tests for resistance of furniture to cleaners is based upon typical cleaning of one time per day and a furniture life of 7 years. This furniture life is based on input from a variety of health care professionals; furniture is often replaced based on aesthetic/appearance considerations needed to maintain a perception of cleanliness and clinical credibility within a facility. This life is not necessarily based on the structural durability of the products.<h4>2. Product Assessment</h4>Designing products for the healthcare environment has unique challenges as the needs from facility to facility are varied. Therefore, this Guideline is intended to provide direction to manufacturers, specifers, and users of healthcare furniture, but is not a mandate of conformance. The test guidelines are primarily ‘should’ rather than ‘shall’ given the unique needs in the healthcare environment. Manufacturers, specifiers, and users should determine relevant requirements based upon their specific needs.<h4>3. Background</h4>Note: In addition to those stakeholders listed in the Foreword and Acknowledgements, guidance is also taken from:<ul><li>“CDC Guidelines for Disinfection and Sterilization in Healthcare Facilities” by Healthcare Infection Control Practices Advisory Committee (HICPAC), Chapel Hill, NC (2008)</li><li>“Guidelines for Environmental Infection Control in Healthcare Facilities” by (HICPAC), Atlanta, GA (2003)</li><li>“Best Practices for Environmental Cleaning for Prevention and Control of Infections - In All Health Care Settings” by the Provincial Infectious Diseases Advisory Committee (PIDAC), Toronto, Canada (2009)</li><li>"Practice Guidance for Healthcare Environmental Cleaning: The Essential Resource for Environmental Cleaning and Disinfection," 2nd ed., Association for the Healthcare Environment of the 91��, (2012)</li></ul>Health care settings are complex environments that contain a large diversity of microbial flora, many of which may constitute a risk to the clients/patients/residents, staff and visitors in the environment. The consequences of transmission of microorganisms within a health care setting may be more severe. High-touch environmental surfaces of the health care setting hold a greater risk than do public areas of non-health care organizations, due to the nature of activity performed in the health care setting and the transient (chair-to-chair, for example) behavior of patients with heightened susceptibility, bacterial colonization among clinical staff, employees, patients and visitors within the health care setting, which increases the likelihood of direct and indirect contact with contaminated surfaces. Transmission involves:<ol><li>presence of an infectious agent (e.g. bacterium, virus, fungus) on equipment, objects and surfaces in the health care environment;</li><li>a means for the infectious agent to transfer from patient-to-patient, patient-to-staff, staff-to-patient or staff-to-staff; and</li><li>presence of susceptible clients/patients/residents, staff and visitors.</li></ol>In the health care setting, the role of environmental cleaning is important because it reduces the number and amount of infectious agents that may be present and may also eliminate routes of transfer of microorganisms from one person/object to another, thereby reducing the risk of infection. There are five parameters, which influence the effectiveness of cleaning and disinfection: contact time, temperature, concentration, mechanical action, and pH. Upholstery cleaning presents different challenges than other surfaces, primarily due to the wide variety of textile fibers, porosity, durability, and stain resistance.Furniture manufacturers are interested in these factors as they impact the design, geometry, materials, finishes/textiles, and mechanisms used, in the overall cleanability of furniture.<h4>4. Definitions/Terminology</h4>Notes:<ul><li>Refer to BIFMA PD-1 Mechanical Test Definitions for related terms not included in this guideline. Otherwise, the common dictionary definition shall be used for terms not defined in this section or in BIFMA PD-1. In case of a conflict between the definitions in this guideline and PD-1, the definitions in this guideline shall apply.</li><li>Some of these definitions were taken from “CDC Guidelines for Disinfection and Sterilization in Healthcare Facilities” by Healthcare Infection Control Practices Advisory Committee (HICPAC), Chapel Hill, NC (2008), and from “Best Practices for Environmental Cleaning for Prevention and Control of Infections - In All Health Care Settings” by the Provincial Infectious Diseases Advisory Committee (PIDAC), Toronto, Canada (2009). Other definitions were provided by the authors of this guideline.</li><li>These terms are provided for reference as they are often used in health care settings. Inclusion within this section does not necessarily mean they are used within the text of this guideline.</li></ul>Alcohol-based Hand Rub (ABHR): A liquid, gel or foam formulation of alcohol (e.g., ethanol, isopropanol) which is used to reduce the number of microorganisms on hands in clinical situations when the hands are not visibly soiled. ABHRs contain emollients to reduce skin irritation and are less time-consuming to use than washing with soap and water.Antimicrobial Products: substances or mixtures of substances designed to destroy or suppress the growth of harmful microorganisms, whether bacteria, viruses, or fungi on inanimate objects or surfaces. These products are typically used for two purposes:<ol><li>Disinfect, sanitize, reduce or mitigate growth of development of microbiolical organisms.</li><li>Protect inanimate objects (floors, walls and/or furniture), industrial processes or systems, surfaces, water, or other chemical substances from contamination, fouling, or deterioration caused by bacteria, viruses, fungi, protozoa, algae, or slime.</li></ol>BIFMA: Business and Institutional Furniture Manufacturer’s Association, a not-for-profit trade association of furniture manufacturers and suppliers.Chemical Sterilant: Kills spores with prolonged exposure times (3 – 12 hours).Cleanability: The ability to be cleaned; easily and without damage. To be maintained in an unsoiled appearance.Cleaning: The removal of visible soil (e.g., organic and inorganic material) from objects and surfaces that normally is accomplished manually or mechanically using water with detergents or enzymatic products. Thorough cleaning is essential before high-level disinfection and sterilization because inorganic and organic materials that remain on the&nbsp; surfaces of instruments interfere with the effectiveness of these processes. See also Disinfection, Sterilization. Note: high-level disinfection and sterilization is not covered by this document. Only hospital-grade surface sanitizer use for low- or intermediate-level disinfection is covered.Cleaning Residue: the material left behind following the cleaning or disinfecting of surfaces. Residue tends to be left or will build up if the cleaning agent is left to air dry (contact time is passed) or used incorrectly. Coated Fabrics: A textile or similar substrate that is surfaced with one or more layers of a film-forming polymer such as vinyl or polyurethane. Construction Clean: Cleaning performed at the end of a workday by construction workers that removes gross soil and dirt, construction materials and workplace hazards. Cleaning may include sweeping and vacuuming, but usually does not address horizontal surfaces or areas adjacent to the job site. Contamination: The presence of an infectious agent on hands or on a surface such as clothes, gowns, gloves, bedding, toys, surgical instruments, patient care equipment, dressings or other inanimate objects. Detergent: A synthetic cleansing agent that can emulsify oil and suspend soil. A detergent contains surfactants that do not precipitate in hard water and may also contain protease enzymes (see Enzymatic Cleaner) and whitening agents.Discharge Cleaning: See Terminal Cleaning Disinfectant: A product that is used on surfaces or medical equipment/devices which results in disinfection of the equipment/device. Disinfectants are applied only to inanimate objects. Some products combine a cleaner with a disinfectant. See also Cleaning, Sterilization. Disinfection: The inactivation of disease-producing microorganisms. A process that eliminates many or all pathogenic microorganisms, except bacterial spores, on inanimate objects. Medical equipment/devices must be cleaned thoroughly before effective disinfection can take place. See also, Disinfectant, Cleaning, Sterilization.<ul><li>Low-Level Disinfectant: agent that destroys all vegetative bacteria (except tubercle bacilli), lipid viruses, some non-lipid viruses, and some fungi, but not bacterial spores.</li><li>Intermediate-Level Disinfectant: agent that destroys all vegetative bacteria, including tubercle bacilli, lipid and some non-lipid viruses, and fungi, but not bacterial spores.</li></ul>Double Cleaning: Repeating a cleaning regimen immediately after it has been done once. Double cleaning is not the same as cleaning twice per day. Enzymatic Cleaner: A pre-cleaning agent which contains enzymes that break down proteins, fats and carbohydrates, such as blood, body fluids, secretions and excretions from surfaces and equipment. Most enzymatic cleaners also contain a detergent. Enzymatic cleaners are used to loosen and dissolve organic substances prior to cleaning. Protease enzymes break down proteins, lipase proteins break down fats and amylase enzymes break down starches and carbohydrates. Germicide: An agent that can kill microorganisms, particularly pathogenic or disease causing germs. Hand Hygiene: A general term referring to any action of hand cleaning. Hand hygiene relates to the removal of visible soil and removal or killing of transient microorganisms from the hands. Hand hygiene may be accomplished using soap and running water or an alcohol-based hand rub (ABHR). Hand hygiene includes surgical hand antisepsis. Hand Washing: The physical removal of microorganisms from the hands using soap (plain or antimicrobial) and running water. Hazardous Material (Chemical) Spills: Any spill of a material that requires specific or specialized handling or methodologies as part of the clean-up protocol. These hazardous materials can include chemicals, cleaning agents, medicines/medications /chemotherapy agents, etc.Hazardous Material (Biological/Blood-Borne) Spills: Any contamination by biological secretion/excretion such as blood, body fluids and fecal material that require specific or specialized handling methodology as part of the clean-up protocol. Health Care Environment: People and items which make up the care environment (e.g., objects, medical equipment, staff, clients/patients/residents) of a hospital, clinic or ambulatory setting, outside the immediate environment of the client/patient/resident. See also, Environment of the Client/Patient/Resident. Health Care Facility: A permanent or mobile facility that supports the delivery of health-related services. A health care facility does not include a client/patient/resident’s home or physician/dental/other health offices where health care may be provided. High-Touch Surfaces: High-touch surfaces are those that have frequent contact with hands. Examples include all seat surfaces except the underside and base, table top surfaces, cart top surfaces, and fronts of cabinets. Hospital Clean: The measure of cleanliness routinely maintained in client /patient/resident care areas of the health care setting. Hospital Clean is ‘Hotel Clean’ with the addition of disinfection, increased frequency of cleaning, auditing and other infection control measures in client/patient/resident care areas. Hospital-Grade Disinfectant: A low-level disinfectant that is registered by the EPA for pesticidal control of microorganisms which pose a threat to human health. Hospital disinfectants are tested by the EPA after release into the market to verify antimicrobial claims and chemical formulations. The list of products found to be efficacious by the EPA is given here: <a href="http://www.epa.gov/oppad001/atp-product-list.pdf">http://www.epa.gov/oppad001/atp-product-list.pdf</a>.Hotel Clean: A measure of cleanliness based on visual appearance that includes dust and dirt removal, waste disposal and cleaning of windows and surfaces. Hotel clean is the basic level of cleaning that takes place in all areas of a health care setting. Infection: The entry and multiplication of an infectious agent in the tissues of the host. Asymptomatic or sub-clinical infection is an infectious process running a course similar to that of clinical disease but below the threshold of clinical symptoms. Symptomatic or clinical infection is one resulting in clinical signs and symptoms (disease). Infectious Agent: A microorganism, i.e., a bacterium, fungus, parasite, virus or prion, which is capable of invading body tissues, multiplying and causing infection. Low-Level Disinfection (LLD): Level of disinfection required when processing non-invasive medical equipment (i.e., non-critical equipment) and some environmental surfaces. Equipment and surfaces must be thoroughly cleaned prior to low-level disinfection. Low-Touch Surfaces: Surfaces that have minimal contact with hands. Examples include the underside of seating surfaces, chair bases, underside and legs of tables, underside and base of carts, and backside and inside of cabinets. Manufacturer: Any person, partnership or incorporated association that manufactures and sells medical equipment/devices under its own name or under a trade mark, design, trade name or other name or mark owned or controlled by it. Medical Equipment/Device: Any instrument, apparatus, appliance, material, or other article, whether used alone or in combination, intended by the manufacturer to be used for human beings for the purpose of diagnosis, prevention, monitoring, treatment or alleviation of disease, injury or handicap; investigation, replacement, or modification of the anatomy or of a physiological process; or control of conception.Noncritical Medical Equipment/Device: Equipment/device that either touches only intact skin (but not mucous membranes) or does not directly touch the client/patient/resident. Reprocessing of noncritical equipment/devices involves cleaning and may also require low-level disinfection (e.g., blood pressure cuffs, stethoscopes, furniture). Permeability: as used here; the resistance that a material or combination of materials provides to the penetration of liquids to the other side of the material or combination of materials. Non-porous: surfaces or barriers that are impermeable to moisture. Typically these include surfaces such as plastics, laminates, some wood finishes, non-perforated coated fabrics (e.g., some vinyl and polyurethanes) and metals (including coated/finished). Barrier materials such as membranes, films, laminations, etc., may also be considered non-porous.Safety Data Sheet (SDS): A document that contains information on the potential hazards (health, fire, reactivity and environmental) and how to work safely with a chemical product. It also contains information on the use, storage, handling and emergency procedures all related to the hazards of the material. SDSs are prepared by the supplier or manufacturer of the material. Spaulding Classification System to Levels of Disinfection: Instruments and items for patient care are divided into three categories based on the degree of risk of infection.<ul><li>Critical: High risk of infection, used on tissues that are sterile or in the vascular system. Spores must be eliminated by sterilization. Examples of this equipment include surgical instruments in surgery.</li><li>Semi-critical: Items that come into contact with mucous membranes or non-intact skin. Examples are respiratory therapy equipment, GI endoscopes, bronchoscopes, etc. These items must be free of all microorganisms although small numbers of bacterial spores may be present after high-level disinfection.</li><li>Non-critical: Items that come in contact with intact skin but not mucous membranes. Examples include: blood pressure cuffs, crutches, bedrails, bedside tables, and patient furniture. Most non-critical reusable items can be disinfected where they are used and do not need to be transported to a central processing area.</li></ul>Sterilization: Destroys or eliminates all microorganisms using chemical and physical means. Terminal Cleaning: The thorough cleaning of a client/patient/resident room or bed space following discharge, death or transfer of the client/patient/resident, in order to remove contaminating microorganisms that might be acquired by subsequent occupants and/or staff.Workstation: A group of furniture items and components where a person performs work.<h4>5. Cleaning Agents/Disinfectants Typically Used for Healthcare Furniture</h4>At the time of writing of this Guideline, the materials listed below were those most commonly used in healthcare facilities and are specifically covered by this guideline in the cleaning evaluation methodologies and criteria. The typical concentrations given should be used for testing for generic products. If other concentrations are expected to be used, those concentrations should be evaluated by the method given below. If the evaluation methodologies and criteria given in this guideline are used for other cleaning/disinfection agents the manufacturer’s instructions for use (IFU) should be followed. Any deviation from concentrations or reagents used for testing should be noted in any test reports or conformance statements.Notes:<ul><li>Cleaning Agents/Disinfectants should be approved by the appropriate department(s) within the healthcare facility.</li><li>By law, all applicable label instructions on EPA-registered1 products must be followed. If the user selects exposure conditions that differ from those on the EPA-registered product label, the user assumes liability for any injuries resulting from&nbsp; off-label use and is potentially subject to enforcement action under the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA).<ul><li>The following website lists all post-market hospital-grade disinfectants that have been tested by the EPA: http://www.epa.gov/oppad001/atp-product-list.pdf</li><li>The following website gives EPA's complete list of disinfectants registered as effective against various pathogens: http://www.epa.gov/oppad001/chemregindex.htm</li><li>Acute care hospitals are required to use EPA registered disinfectants intended for health care use.</li><li>See this list of all disinfectants registered with specific microorganism claims: <a href="http://www.epa.gov/oppad001/chemregindex.htm">http://www.epa.gov/oppad001/chemregindex.htm</a>.</li><li>Note that not all registered products have been tested and confirmed by the EPA as efficacious against their pre-market label claims. Only those products listed by the EPA above as "Agency Confirmed Efficacy" in post-market testing should be considered for materials compatibility testing.</li><li>Furniture manufacturers are encouraged to test surface materials using products that are EPA registered hospital-grade disinfectants.</li></ul></li><li>Cleaning residue left by cleaning agent residue may continue to degrade surfaces and shorten their life and/or affect their appearance. Manufacturers may recommend a final rinse with a clean damp cloth to remove residue.</li><li>Any specific cleaning materials (including name brands) given in the list below are given for purposes of testing consistency only. They are not given as recommendations or endorsements.</li><li>Contact/dwell time for any cleaning/disinfecting agent is important and will typically vary depending on the IFUs (Instructions For Use) provided by the manufacturer.</li></ul>5.1 Bleach: sodium hypochlorite2 in a 5.25 - 6.25% dilution is an intermediate level disinfectant (use label recommendation for mixing bleach with water – typical is 10:1 water to bleach). Bleach is one of the few agents that are registered and tested as effective against Clostridium difficile, although chlorine dioxide has also been tested by the EPA as efficacious. See this list of all disinfectants registered with C. diff. claims: <a href="http://www.epa.gov/oppad001/cdif-guidance.html">http://www.epa.gov/oppad001/cdif-guidance.html</a>; note that not all registered products have been tested as efficacious against their pre-market label claims. 5.2 Peroxide: in a 3.0% solution, sometimes accelerated with acid, hydrogen peroxide can be either a low or intermediate level disinfectant, depending on the specific product formulation. Some peroxide products meet the EcoLogo product labeling requirements and may be used in green cleaning programs adopted by healthcare facilities to meet green certification requirements. Hydrogen peroxide plasma or misting applications are not covered in this guideline. 5.3 UV lights: The wavelength of UV radiation ranges from 210 to 328 nm (2100 to 3280 A) at 2-6 mw/cm2. 200-280 nm is typically considered to be the UVC range. (The maximum bactericidal effect of Ultraviolet light occurs at 254 nm. Cycle time exposures are determined by the lamp manufacturer, and lamps should not be used in the presence of humans). 5.4 Alcohol: Isopropyl and ethyl alcohol at 55-70%, and usually used in combination with quaternary ammonium salts or as 70% isopropyl alcohol, can be effective against Mycobacterium tuberculosis. See this list of all disinfectants registered with specific microorganism claims: <a href="http://www.epa.gov/oppad001/chemregindex.htm">http://www.epa.gov/oppad001/chemregindex.htm</a>. (Alcohol is limited in use but is typically used when it’s convenient, for example – alcohol wipes might be in the room and a staff person will use them for minor cleaning). 5.5 Quaternary Ammonium (Quats): low level disinfectants that will kill most bacteria, viruses and fungi. Some Quats alone without phenolics or alcohol may not be effective against Mycobacterium tuberculosis, but are commonly used as the routine disinfectant product in healthcare applications. Quaternary ammonium compounds effectively remove and/or inactivate lesser-resistant microorganisms such as Stapholococci aureus, vancomycin-resistant Entercoccus, P. aeruginosa] from surfaces. Refer to the EPA registered products listed on their website for specific claims. (One such product is PDI Hospital Disinfectant Cleaner).<ul><li>The following website gives EPA's complete list of disinfectants registered as effective against various pathogens: <a href="http://www.epa.gov/oppad001/chemregindex.htm">http://www.epa.gov/oppad001/chemregindex.htm</a></li></ul>5.6 Phenolic: intermediate level disinfectants that are effective against Mycobacterium&nbsp;tuberculosis; however, due to toxicity and environmental concerns they are being phased out of common use. Refer to the EPA registered products listed on their website for specific claims. (One such product is Wexcide 128).<ul><li>The following website gives EPA's complete list of disinfectants registered as effective against various pathogens: <a href="http://www.epa.gov/oppad001/chemregindex.htm">http://www.epa.gov/oppad001/chemregindex.htm</a></li></ul>5.7 Steam: The vapor into which water is converted when heated. In healthcare, steam may be used to get rid of bed bugs and other infestations, and/or other infectious agents in upholstered furniture.5.8 Chlorine Dioxide: intermediate level disinfectant in a 2.0 - 5.0% concentration. Although effective against C. diff., its use is not widespread in healthcare applications. Refer to the EPA registered products listed on their website for specific claims. (One such product is International Dioxide’s Anthium Dioxide).Note: For Sections 6 – 8, testing should be conducted in an environment of 70 deg +/- 6, and 50% RH +/- 15%. Samples should be preconditioned for at least 4 hours prior to testing. Deviations from the temperature, humidity, and preconditioning parameters should be noted in the test report. 6. Screening of Finishes to Liquid Cleaner Resistance 6.1 Applicability This test applies to all non-porous furniture materials subject to cleaning/disinfection in the healthcare setting. This test does not apply to woven textile surfaces nor coated fabrics. See Section 7 for coated fabrics. 6.2 Purpose of Test The purpose of this test is to evaluate the ability of furniture surfaces to withstand the application of liquid cleaners/disinfectants. 6.3 Test Setup Prepare the surface for testing by cleaning with a clean damp cloth (distilled water) and allow it to dry. Place the test sample on a level surface. If the surface geometry of the product does not allow for testing per the following procedure, representative samples of the finish/substrate combinations may be used. Each reagent used for testing should be at the manufacturer’s ready to use concentration or dilution as specified in their Instructions For Use, but conforming to Section 5. 6.4 Test Procedure 6.4.1 Place a one-inch square 100% cotton cloth on the surface to be tested. For each reagent listed, apply enough of the reagent to saturate the cloth or paper (use of an eye-dropper or pipette is recommended).<ul><li>Distilled water (control)</li><li>Bleach (diluted 10:1 water-to-bleach from bleach concentrate per 5.1)&nbsp;</li><li>Hydrogen Peroxide</li><li>Quaternary Ammonium (diluted per manufacturer’s instruction*)</li><li>Alcohol - Isopropyl</li><li>Phenolic (diluted per manufacturer’s instruction*)</li></ul>* Manufacturers may also want to consider effect of full-concentration applications for information only – no acceptance criteria. 6.4.2 Immediately cover the reagent with a 2 in. diameter watch glass. 6.4.3 Allow the reagent to remain covered for 15 minutes. 6.4.4 Remove the watch glass and remove the reagent with a clean cloth.6.4.5 Wipe the test area with a clean cloth and distilled water.&nbsp;6.4.6 Allow the surface to air dry for 1 hour.6.4.7 Evaluate the product to the acceptance level in 6.5.6.5 Acceptance LevelThe reagents should not affect the color of the surface. There should be no tackiness to the surface or softening of the surface/finish as compared to the unreacted surface. There should be no cracking or crazing of the surface. For products with an initial Gloss reading of 20 or greater, a gloss change of up to 25% is acceptable. For example, products with an existing gloss reading of 40, should not fall below 30. (60-degree Glossmeter) For products with an existing Gloss reading of 20 or less, a gloss change of up to 5 points is acceptable.<h4>7. Screening of Coated Fabrics* to Liquid Cleaner Resistance</h4>Note: The Association for Contract Textiles (ACT) has created the following test method as a possible tool for determining the effect of liquid cleaners on coated and woven fabrics*. In order to validate the test, ACT members are evaluating the protocol described in 7.1 through 7.5. This evaluation was not completed at the time of BIFMA HCF 8.1-2014 publication date. *Test method was originally written for coated fabrics. It is currently being evaluated for it’s applicability to woven fabrics as well. The BIFMA Healthcare Furniture Subcommittee made a few modifications to the ACT proposal.7.1 Applicability The following is a suggested protocol for the testing of cleaners and/or disinfectants on coated fabrics*. The test method outlined is to evaluate the material’s relative resistance or compatibility to specific cleaners and/or disinfectant chemistries and is not an approval or recommendation of said cleaners and or/disinfectants. This test method is not intended to replicate a ‘real world’ scenario as there is no way to predict use (or misuse) of cleaners and/or disinfectants within an environment. 7.2 Purpose of Test The purpose of this test is to evaluate the ability of coated fabrics* used for furniture surfaces to withstand the application of liquid cleaners/disinfectants. 7.3 Test Setup Utilize a minimum of 254 mm x 254 mm (10-inch x10-inch) piece of coated fabric*. Provide enough cleaner and/or disinfectant for 6 applications per day for a 14 working day test period. i.e. Cleanings (Wipes) required – Minimum of 84 cleaning (wipes) would be required to complete test. Place the test sample on a level surface. Each reagent used for testing should be at the concentration given in Section 5.7.4 Test Procedure 7.4.1 Using indelible marker or No. 2 pencil divide the 254 mm x 254 mm (10-inch x 10-inch) piece of material into two 127 mm x 254 mm (5-inch x 10-inch) sections by drawing a line down the center. Label the left side with cleaner name and test initiation date. The left side is to remain the control for visual comparison reference. The right side is the only side in which the cleaner and/or disinfectant is to be applied. 7.4.2 Lay the 254 mm x 254 mm (10-inch x 10-inch) piece of material on flat surface. 7.4.3 Apply cleaner/disinfectant to surface of entire right side of material as instructed on label (proper dilution and application method i.e. wipe, spray bottle or both). With standard cleaning pressure wipe entire right half surface with a clean dry cloth using standard cleaning motion (circular or back and forth) for a minimum of 10 times. Allow to either air dry or apply clean water rinse as instructed on label.<ul><li>If label calls for air dry and does not call for clean water rinse it is recommended to run a second test using the same cleaner/disinfectant with the addition of a clean water rinse (and wipe dry) after application to determine if there is a significant difference when testing is completed.</li></ul>Repeat recommended application method 6 times per day for a 14 working day period.7.5 Acceptance Level After each application the right half of the test specimen should be reviewed and compared to the control side (left) for visual differences such as: General Appearance (in some instances this may include gloss) –<ul><li>No effect -- no change in color or surface finish.</li><li>Slight effect -- a change in color or surface finish only visible at certain angles or directions.</li><li>Moderate effect -- a change in color or surface finish visible from all angles and directions, but does not appreciably alter the original condition of the specimen.</li><li>Severe effect -- a change in color or surface finish, which obviously and markedly alters the original condition of the specimen.</li></ul>General Appearance – Not acceptable beyond slight effect as noted above. Discoloring – Not acceptable beyond slight effect as noted above. Cracking or peeling – Not acceptable Enhanced Crocking – Not acceptable Bubbling - Not acceptable<h4>8. Resistance of Furniture to Steam Exposure</h4>8.1 Applicability This test applies to all furniture items/materials including textile-covered surfaces subject to steam exposure for purposes of killing pests. 8.2 Purpose of Test The purpose of this test is to evaluate the ability of furniture surfaces to withstand steam applications. 8.3 Test Setup (See Figure 1) Prepare the surface for testing by cleaning with a clean damp cloth and allow it to dry. Place the test sample on a level surface. The test shall include: 8.3.1 NEMA cup found in NEMA LD-3 Section 3.5. 8.3.2 Heating apparatus to heat the cup. 8.3.3 Structure to hold the material ½-inch above the cup.<img src="/sites/default/files/inline-images/BIFMAfigure1.png" data-entity-uuid="8fc985e5-0339-4277-9b0a-b673cd1717d1" data-entity-type="file" alt="Figure 1 - Steam Exposure" width="496" height="368"> Figure 1 - Steam Exposure<h4>8. Test Procedure</h4>8.4.1 Follow the general guidelines given in NEMA LD-3 Section 3.5. Place 350 ml of distilled water in a NEMA vessel found in Section 3.5. 8.4.2 Place the cup filled with water on a hot plate, until the water is at a vigorous boil. 8.4.3 After steam is rising from the vessel, place the material ½ inch from the top of the container. 8.4.4 Time the steam exposure to 30 seconds. It will be evident that steam is in contact with the surface by condensation forming on the surface. 8.4.5 After 30 seconds, remove the sample from the steam exposure and wipe any remaining water away with a dry paper towel. 8.4.6 Allow the surface to dry completely. After one hour evaluate the appearance of the surface according to the following:<ul><li>No effect -- no change in color or surface finish.</li><li>Slight effect -- a change in color or surface finish only visible at certain angles or directions.</li><li>Moderate effect -- a change in color or surface finish visible from all angles and directions, but does not appreciably alter the original condition of the specimen.</li><li>Severe effect -- a change in color or surface finish, which obviously and markedly alters the original condition of the specimen.</li></ul>8.5 Acceptance Level The test surface shall show no more than a slight effect.<h4>9. Resistance of Furniture to UV Lights</h4>9.1 Applicability This test applies to all furniture materials subject to UV wavelength disinfection in the healthcare setting. (An alternate to this test is to subject the sample(s) to 40 hours per ASTM G155 Standard Practice for Operating Xenon Arc Light Apparatus for Exposure of Non-Metallic Materials). 9.2 Purpose of Test The purpose of this test is to evaluate the ability of furniture surfaces to withstand UV wavelength disinfection. 9.3 Test Setup The test apparatus shall include: 9.3.1 A germicidal light source capable of providing radiant energy in the spectral UVC wavelength region (200-280 nm), with the majority of the radiation at 254 nm. 9.3.2 A cabinet or otherwise means to isolate the light source and a mounting surface with uniform irradiation for sample exposure. 9.3.3 Overhead white fluorescent lights with bulb(s) positioned parallel to the line of sight and providing an intensity of 800 to 1100 lux (75 to 100 ft-ca) on the specimen surface. 9.3.4 A spectrophotometer if CIE L*a*b* readings are desired. 9.4 Test Procedure Apply a UVC light source to achieve 291 kJ/m2 (+/- 15 kJ/m2) radiation within 12 to 24 hours. GE G36T5 UVC lamp applies 500 uW/cm2 irradiation at 16 inches to achieve this dose in 16 hours. Any similar UVC germicidal light source is satisfactory. 9.4.1 Measure the light intensity after a warm up period sufficient to achieve stable irradiation. Determine the exposure time necessary to achieve 291 kJ/m2. Sper Scientific UVC Light Meter, Model 850010, or similar is satisfactory to measure irradiation. 9.4.2 Establish initial L*a*b* readings if color values are used. For wood surfaces identify the location so that subsequent readings may be made in the same location. Disregard if only visual assessment is used. Uniform color surfaces may be measured in exposed and unexposed areas after the exposure, if desired.9.4.3 Cover approximately 1/2 the sample with aluminum foil or other mask; across the grain for wood surfaces. Sample size of 100 mm x 200 mm (4 in. x 8 in.) is suggested. 9.4.4 Up to four samples may be tested at once by placing the unmasked ends of the four samples together in a 200 mm x 200 mm (8 in. x 8 in.) sample area centered under the lamp. Placing the samples within this area minimizes the irradiation variation to +/- 5%. Expose the sample in UVC light until 291 kJ/m2 (+/- 15 kJ/m2) is achieved. 9.4.5 Establish final L*a*b* readings as appropriate. For visual assessment position the conditioned sample on a table and view it at an eye- to-sample distance of approximately 750-900 mm (30-36 in.) and at an angle of approximately 45-75 degrees from the horizontal plane. The sample shall be rotated in the horizontal plane and viewed from all directions. Direct sunlight or other angle light sources, which can accentuate or minimize the effects shall be avoided. 9.4.6 The light resistance shall be reported as one of the following:<ul><li>No effect—no change in color or surface gloss.</li><li>Slight effect—a change in color or surface gloss visible only at certain angles and directions.</li><li>Moderate effect—a change in color or surface gloss visible at all angles and directions but does not notably alter the original condition of the specimen.</li><li>Severe effect—a change in color or surface gloss, which markedly alters the original condition of the specimen.</li></ul>9.5 Acceptance Level The test surface shall show no more than a slight effect by visual assessment. The test surface shall show a delta E of 2.0 or less. 9.6 Background UVC Germicidal Exposure The Centers for Disease Control (CDC) recognizes that UVC light, wavelength 200- 280 nm, has a germicidal effect on microorganisms and its use has widespread commercial acceptance as a method to disinfect bacteria, viruses, mold and spores(1). Peak germicidal effectiveness occurs at 254 nm by damaging the DNA of microorganisms and rendering them unable to replicate. Typically germicidal low-pressure mercury vapor lamps have a peak output of 254 nm and are commonly used in commercial portable disinfection systems(2-3). Several companies produce UVC disinfection systems and many studies have shown the effectiveness of using this technique to kill harmful microorganisms(4).Studies applied UVC doses of 12,000 uWs/cm2 to 36,000 uWs/cm2 achieved in times ranging from 15 to 50 minutes to achieve Log 2-4 kill rates of MRSA, VRE, and Clostridium difficle (5-8). C. difficle is recognized as a primary pathogen causing healthcare associated infections and is among the most difficult to disinfect (9). Killing C. difficle may be considered a benchmark for effective disinfection. One time UVC exposure to kill C. difficle is in the order of 0.8 kJ/m2 [10]. This is at the high end of reported UVC disinfection doses; therefore this dose should be sufficient to kill nearly all pathogens at a Log4 kill rate. Seven years has been proposed for the life statement for the Healthcare Furniture Cleaning Guideline (BIFMA H1-201X). Weekly exposure for 7 years gives a total germicidal dose of 291 kJ/m2. Therefore, a total exposure of 291 kJ/m2 using a germicidal lamp operating at 254 nm output is suggested to represent germicidal exposure to be addressed by the Healthcare Furniture Guideline.<h4>References:</h4><ol><li>CDC Guideline for Disinfection and Sterilization in Healthcare Facilities, pg. 54, 2008.</li><li>Steris Pathogen UV Disinfection System: http://webapi.steris.com/api/salesconnection/getdocumentbynumber?id=SD970&amp;fileName=PATHOGON%20UV%20DISINFECTION%20SYSTEM.pdf&nbsp;</li><li>UV Lamps for Germicidal Applications: http://www.gelighting.com/LightingWeb/br/images/Germicidal_Lamps_Brochure_EN_tcm388-12723.pdf</li><li>TruD Smart UVC Room Disinfection: http://www.tru-d.com/studies.html</li><li>Comparison of UV C Light and Chemicals for Disinfection of Surfaces in Hospital Isolation Units. B. M. Andersen, MD, PhD; H. Bånrud, DrScient; E. Bøe, BcEcon, MEng; O. Bjordal, MEng; F. Drangsholt, PhD Infection Control and Hospital Epidemiology, Vol. 27, No. 7 (July 2006) (pp. 729-734) http://www.jstor.org/stable/full/10.1086/503643</li><li>Room Decontamination with UV Radiation, Infection Control and Hospital Epidemiology, Oct. 2010. http://www.uv-clean.co/downloads/UV-rutala.pdf</li><li>Evaluation of an Automated Ultraviolet Radiation Device for Decontamination of Clostridium difficle and other Healthcare-Associated Pathogens in Hospital Rooms: http://www.biomedcentral.com/content/pdf/1471-2334-10-197.pdf</li><li>American Air and Water, UV Irradiation Dosage Table: http://www.americanairandwater.com/uv-facts/uv-dosage.htm</li><li>Elimination of Clostridium difficle by Illumination? Surface Disinfection by Ultraviolet Light Treatment: http://www.trud.com/docs/Elimination_of_clostridium_difficile_by_illumination.pdf</li><li>Email from Deborah Martinez, Executive Director, International Ultraviolet Association, 11/21/13.</li></ol><h4>Appendix 1: Furniture Cleanability Design Considerations</h4>Surfaces in Health Care Settings a) Non-upholstered surfaces should be capable of being easily cleaned; minimize surface joints and seams.<ul><li>Joints and seams complicate effective cleaning, creating organism reservoirs that can further the spread of contact transmitted healthcare associated infections.</li><li>A space between the chair back and seat can facilitate cleaning.</li><li>Nonporous, smooth solid surfaces such as laminate or poly resin products facilitate effective cleaning. Textured surfaces may result in additional cleaner dwell time or cleaning cycles, however, they may also decrease skin/surface contact area, which may lead to decreased bacterial transmission.</li><li>Finishes on hard surfaces that are scratched or chipped allow for accumulation of microorganisms and make them more difficult to clean and disinfect.</li><li>Furnishings must be able to withstand cleaning and be compatible with clinical practice and hospital-grade detergents, cleaners and disinfectants.</li><li>Organic substrates (e.g., unfinished wood) should be avoided in hospital areas with immunocompromised patients; all exposed wood surfaces should be sealed/finished such that they are and remain nonporous.</li><li>Surfaces that require high levels of cleaning/disinfecting, such as armrests, should have large radii along edges.</li><li>Inside radii on adjacent (cove) surfaces to avoid entrapment of materials and permit effective cleaning; larger inside radii are preferred.</li><li>Abutting surfaces should have minimal radii to avoid creation of crevices that are difficult to clean. Example – adjacent work surfaces.</li><li>Effective cleaning can be facilitated using support surfaces that can be cleaned from both sides, and/or by using materials that do not absorb or hold fluids/moisture, etc. Seating support surfaces using slings, mesh and similar materials are encouraged for such use. Such surfaces also allow for effective cleaning of under surfaces and support structures.</li></ul>b) Upholstered Furniture (or Surfaces) in Patient Care Areas<ul><li>The following types of high-performance (durable, stain-resistant and easy-to-clean) upholstery fabrics are currently used extensively in healthcare patient spaces. These fabrics can be, and are being, aggressively cleaned and disinfected with a wide range of popular disinfectants. Fabric supplier recommendations and limitations—in conjunction with healthcare facilities and their infection-control specialists or advisors (e.g., Centers for Disease Control) and housekeeping staff—determine appropriate use according to the demands of each specific space.<ul><li>Coated fabrics such as PVC (vinyl), PU (polyurethane), composites, silicone.</li><li>Woven fabrics treated with stain-resistant finishes and fluid barriers that are designed to prevent moisture and liquids from penetrating the fabric.</li><li>100% polyester woven fabrics that utilize high-energy dyes, stainresistant finishes (or both), with fluid barriers.</li></ul></li><li>Upholstered surfaces used in patient care areas should be impervious (nonporous); untreated (non-high performance) woven &nbsp;fabrics should not be used.</li><li>Upholstered surfaces should be durable and resist tearing, peeling, cracking or splitting; damaged surfaces are more difficult to clean effectively.</li><li>Upholstered furniture in patient care areas should be covered with fabrics that are fluid-resistant, non-porous and can withstand cleaning with hospital-grade disinfectants; microorganisms have been shown to survive on porous fabrics such as cotton, cotton terry, nylon and polyester, and on plastics such as polyurethane and polypropylene.</li><li>Upholstery fabrics that are flatter (or have minimal texture) are preferable and easier to clean.</li><li>Surfaces should also be uninterrupted whenever possible. Avoid crevices, reveals, piping, zippers and other areas that trap dust, dirt and other contaminants.</li><li>If zippers are used, barrier materials should be considered (behind the zipper) to minimize liquid penetration into the cushioning/filling materials, and sealed zippers should be encouraged.&nbsp;</li></ul>c) Ease of maintenance and repair:<ul><li>Products should be designed for ease of cleanability. Where possible, parts (cushions, arm pads, etc.) should be easily removable and/or have removable covers to facilitate cleaning or replacement.</li></ul>d) Other<ul><li>In some instances, products may be subjected to heat or steam to eradicate pests (bed bugs, etc.). The construction and materials used in such products should be moisture resistant (impervious) to avoid damage to the internal components and mechanisms of the products. Consideration should be given to the fastener and component materials and/or finishes to prevent rust and corrosion if they are exposed to moisture and/or cleaning materials.</li><li>The application of hooks &amp; loop style fasteners should be carefully designed to facilitate cleaning (eg, make cushions easily removable for cleaning). Inappropriately designed fastening systems may compromise the cleanability/maintainability of furniture (may collect debris, moisture, etc., and not be easily disinfected).</li><li>The use of antimicrobial inhibitors in materials and finishes is an emerging technology that is currently under investigation. No recommendation is given.</li><li>Stain blocking finishes may be utilized, but are no substitute for good cleaning practices/routines.</li><li>Manufacturers cleaning instructions geared to actual use and clinical practice should be provided for all product materials and finishes.</li></ul>&nbsp; Tue, 11 Apr 2017 10:30:26 -0500 Operations Related to Textile Management Uncovering the Prevalence of Damaged Mattresses /uncovering-prevalence-damaged-mattresses <h4>By Brenda Marks, BN, MBA</h4> February 29, 2016&nbsp;|&nbsp;Formats:&nbsp;Article&nbsp;|&nbsp;Content Areas:&nbsp;Administration&nbsp;|&nbsp;Tags:&nbsp;Beds, Laundry and Textiles, Linen <hr /> Preparing for the next admission is an important task in healthcare facilities. Cleaning and disinfecting all patient care areas is essential to preventing healthcare-acquired infections. In addition, all furnishings and equipment should be regularly inspected to ensure they are safe and properly maintained. So if all environmental services professionals are doing this, why are damaged mattresses so common? Studies have shown that 20 percent to 47 percent of patient mattresses in acute care settings have damaged or worn covers. Damaged covers cannot be properly cleaned and may allow bodily fluids and pathogens to penetrate the mattress core. In 2013, the FDA issued a Safety&nbsp;Communication warning that damaged mattress covers pose a risk of cross-contamination and patient infection and recommended regular inspections of patient mattresses for any visible signs of damage such as tears, cuts, punctures, abrasions or staining. Despite this warning, there may be reasons why damaged mattresses continue to circulate in healthcare facilities. Bed and stretcher mattresses are often a forgotten asset. The CDC Guidelines for Environmental Infection Control were last published in 2003, with subsequent recommendations for isolation precautions in 2007, and disinfection and sterilization in 2008. These guidelines focus on critical versus non-critical surfaces. Bed rails and linens are listed as high-touch surfaces, but mattresses are not — even though patients spend the majority of time in bed. Published environmental cleaning checklists include bed rails, bed controls, and call-bells but do not include mattresses. Recent studies reveal that the bed surface is indeed among the four highest-touch surfaces in the patient environment. Regardless, these studies recommend that efforts to improve room cleaning should be focused on all surfaces, not just high-touch, high-risk objects.&nbsp;The existing 2003 guidelines state that mattress covers must be kept clean, intact, and impermeable to fluids; and should be replaced if there is any visible staining, as wet mattresses can be a substantial environmental source of microorganisms. However, mattress repair is now possible with new product technology. Another point of confusion may be&nbsp;whether mattresses are defined as furniture or medical equipment. Patient beds are categorized as medical devices. Since nursing, facilities, or biomedical engineering staff are generally responsible for medical equipment, environmental services personnel may presume that repairing or replacing a damaged mattress is not their responsibility. Early intervention is the key to preventing a damaged mattress from becoming a contamination risk. It makes practical sense that all patient mattresses are inspected for damage during every terminal cleaning, and that any damage is immediately repaired or the mattress replaced. Environmental services professionals would be more likely to make sure this is completed if it were added to the terminal cleaning checklist. Imagine that a patient comes into the emergency department: He or she is provided with a stretcher and lies down on the freshly laundered linens. After a while, the patient notices a moist sensation and begin to wonder if he or she is incontinent or&nbsp;bleeding. The patient mentions this to the nurse and, after assessing the situation, it is apparent that the fluid is coming from the mattress itself. There is a tear in the cover and the inner foam core is contaminated with bodily fluids from a previous patient, along with any pathogens that patient may have harbored. This may be the worst-case scenario but it has happened. We know that cleaning and disinfection of the patient environment is vital to infection prevention. Patients may have a disinfected bathroom and clean bed rails, but this might not help if they are literally lying on the source of contamination. Mon, 29 Feb 2016 09:23:08 -0600 Operations Related to Textile Management Textiles that Heal /textiles-heal <h4>By Gabriel Boardman</h4> November 29, 2015&nbsp;|&nbsp;Formats:&nbsp;Article&nbsp;|&nbsp;Content Areas:&nbsp;Textile Management Operations&nbsp;|&nbsp;Tags:&nbsp;Beds, Environmental hygiene and sanitation, Laundry and Textiles, Linen <hr /> As we observe the latest trends in health care, two of those trends are glaringly prevalent: our growing concern over infection and cross-contamination, as well as our renewed interest in the greening of our industry. And these two trends are the fruits of an over-encompassing trend: The greying demographics. Our planet has never had to handle so many individuals, but even more so, never has there been such a large percentage of individuals 65 years or older. This affects all geographical markets differently, at varying degrees, but most are developing towards a similar result. It is estimated that by 2030, 55 countries may see their elderly population represent a fifth of their total population. For a country like Japan, it is estimated that percentage could climb as high as 40 percent of their total population. Of course, this hike is partly due to lower birth rates, better health care, and longer life expectancies. Baby boomers (born between 1946 and 1964) will soon all have reached retirement age, and what may be of more concern, when it comes to the trend of greying demographics, is that the next generation in line is generation X; a generation that is more demanding and that will not settle for mediocre compromises. Whether we qualify as baby boomer or gen X, we are the next customers of our&nbsp;health care system. And next in line are our children. This will not be an easy ride! How can we address the needs and the issues that await? What should we focus on to do our part in providing the best services, the best system, and most importantly, the best care? Acute care and senior living will both be under serious pressure to offer services of greater quality and value, and this will undoubtedly have an impact on our linens, among many other things. Here we’ve identified three main areas of development where manufacturers and distributors of health care linens are concentrating their efforts. These were all identified as important factors in addressing the needs of the aging population, and work is being done throughout the industry to strive to address these developing needs. These areas, which are strongly influenced by our greying demographics, are infection control, environmental concerns, and the patient experience. Infection Control As more and more reports of hospital acquired conditions spread, as these concerns grow, patients will be educating themselves, asking questions, wanting to ensure their provider will protect them as best as they can. Once such way to address these concerns has been the vast introduction of anti-microbials, which has been on the radar of textile manufacturers for many years. Many options and variations are offered, and although not suitable for all applications, it is important to keep an eye out on the sector, as changes and progress occur on a regular basis. It is important to understand what each option can deliver and how it meets the expectations of the population that will experience it first-hand. Infection control gowns are also going through many changes, offering varying degrees of protection. Contrary to popular belief, the gowns are primarily designed to protect the patient, whose immune system may be weakened, and not necessarily the person wearing the gown. For that reason, the level of protection can only be ensured&nbsp;if the garment is properly used and worn, paving the way for increased education on best practices within facilities. Some manufacturers are considering, and some already offering, gowns that offer a much more user-friendly closure system for maximized and more efficient protection. Of all the surfaces in a hospital, a patient will have the greatest degree of contact with his/her own gown and the bed linens he/she lies on. Although health care linens present valid concerns to the transmittal of HAIs, as an industry it is our responsibility to present solutions and base conversations on facts. Facts documenting that although many studies address the presence of microbes on textiles, there is little documentation of actual transmission. Also, as many of us are directly related to the laundries that process the linen, it is important to help them be their own strongest advocates. Few reports in literature link laundry to disease transmission when proper procedures are followed. That is a massive statement as currently in the U.S., 10 billion pounds of health care linens are processed each year. To encourage all health care linen manufacturers, this is double what was processed only 30 years ago! Environmental Concerns Our general population is an audience that has been sensitized to environmental concerns. Baby boomers and the like understand the impact of their individual, small decisions having big impacts. This population has experimented with recycling and they make conscious, educated choices daily (electric cars, fair trade coffee beans, pesticide-free vegetables, eco-friendly, naturally dyed, etc.) that allow them to address their own ecological concerns as responsible individuals. For that reason, health care textile professionals often went off the assumption that because individuals made better, more sustainable choices in their personal lives, the same decisions would transfer into the health care environment. Of course, we would all make the obvious ecological&nbsp;choice, wouldn’t we? But as much as we want to believe it, that remains debatable. Landfills that overflow with disposables are difficult to argue against. But disposables are not the only products that have significant impacts on the environment. The reusable industry is consistently looking for ways to diminish their footprint. Products dry faster to minimize the use of fuel and electricity; products have superior stain-release properties to eliminate costly rewash (as well as unnecessary use of water); longer-lasting products minimize the number of discarded; products are washed in cold water whilst using less chemicals; cycles reuse water; some facilities are fully eliminating folding and are instead bulk bagging linen…and the list goes on. As well, and we believe it is one of the most difficult aspects to master, we all strive to provide our customers with options and solutions that are both environmentally conscious and sustainable, whilst fitting into pre-existing budgets. Because no matter how beneficial a product will be to the environment and no matter which generation we identify with, ‘’how much will it cost me today’’ will likely continue to transcend through years and generations. The Patient Experience Two touch points tend to be at the forefront of what we call the patient experience: comfort and care. In the United States, the broader use and awareness of HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) questionnaires are bringing further attention to the discussion around the patient experience. Although there may still be debate over the HCAHPS questions themselves, they can still be looked at as a relevant part of an overall process—these questions can serve to inspire the industry. Health care systems are becoming increasingly customer-centric, even more so in the United States than in most other countries. The patient experience is made of a number of touch points, with hospital&nbsp;linens, patient gowns, and privacy curtains, amongst others, all playing a part. Keep in mind that patients or residents do not surrender their identities as they enter our facilities; they are still consumers, individuals, twitterers, facebookers, and unlike our parents and grandparents, their easy access to communication channels with extraordinary reach has become a natural way of life. The good—but most commonly the bad—gets shared quickly. As participants in the health care community, we want to ensure the image that is communicated is positive. We are not only compared to the competition, or to other facilities, but we are also judged by what is expected by individuals who travel, who get to experience the extremely competitive hospitality market, who are aware of the various options in textiles, and who have made a habit of undergoing a strict selection process when it comes to their own purchases (products and experiences) that will impact their lives or the lives of their loved ones. It is often stated that comfortable, plush, soft, and warm are descriptors that help make patients feel more relaxed, despite being in uncomfortable (institutional) surroundings. These characteristics help recreate familiar surroundings, much like many hotel chains attempt to do. Some of the items that are used in hospital or nursing homes are even labelled as boutique or “hotel-like” linens. These campaigns clearly address the needs of a much more demanding patient/resident population. For that reason, aesthetics, it is believed, will be further incorporated into the conversation tied to comfort. Designers will be tasked with reproducing linens that will help our patients forget where they are so that they can focus on healing. A potential factor in comfort that may be overlooked is noise. The effect of noise in an environment (everything from megaphones, to chatter, to footsteps, to metal tracks) is significant to recovery and to the overall perception of comfort. Facilities are opting for products that are&nbsp;quieter—forsaking vinyl mattress protectors and pillows that crinkle, and cubicle curtains that wake up patients in the middle of the night when they are pulled open for a quick check. The less disruptions there are, the better and faster the patient can heal. Subjectively, comfort is different to each of us. In a hospital environment, however, scientists are beginning to find ways to test for comfort in objective ways by focusing on key factors that affect comfort tied to healing and health. Such factors as microclimate management, contact points on a patient’s being, stiffness of linens, heat buildup (or lack thereof), and breathability are being looking at differently than ever before and are being identified as objective criteria of comfort. No matter which generation or individual we are addressing, finding the balance between the individual preferences and the optimal environment for care is the challenge. Although improving comfort will make a stay a much more pleasant experience, no ‘’comfort’’ improvement alone must ever be made at the expense of patient care. Coming Up As we are all currently involved, at one level or another, in the development of the future of health care linens, let’s ensure we are developing the products we will be happy to experience first-hand. Even more so, let’s make sure we consider and select the linens we will feel proud of when they will be used by the ones we love. Sun, 29 Nov 2015 12:13:26 -0600 Operations Related to Textile Management Plant, Personnel, and Process /plant-personnel-and-process <h1>Plant, Personnel, and Process</h1> <h4>By Gregory Gicewicz</h4> November 29, 2015&nbsp;|&nbsp;Formats:&nbsp;Article&nbsp;|&nbsp;Content Areas:&nbsp;Textile Management Operations&nbsp;|&nbsp;Tags:&nbsp;Laundry and Textiles, Linen , Management, Process Improvement, Staffing Models <hr /> Health care professionals charged with assessing and selecting a textile service provider for their facility have a singular goal: To ensure the laundry provider follows the most rigorous of standards so clean textiles arrive at the facility free of contamination. Therefore, visiting a potential health care laundry is a must and should include relevant representatives from environmental services and infection prevention. During the visit, focus the evaluation on the Three Ps: the plant, the personnel, and the process. Here’s a topline look at those Three Ps (for thorough detail, see the current edition of the Healthcare Laundry Accreditation Council’s “Accreditation Standards for Processing Reusable Textiles for Use in Healthcare Facilities,” available at <a href="https://www.hlacnet.org/" target="_blank">https://www.hlacnet.org/</a>): The Plant 1) How is the plant laid out? Ultimately, as you walk around the facility, you want to get a sense that you’re in a building that has been designed in a way that promotes efficient workflow without compromising the protection and integrity of the health care textiles. Look for circumstances where clean linen might become contaminated. Is there proper airflow from clean to dirty? Are there areas where clean linen may come into contact with dirty linen? There’s no room for shortcuts. 2) Does the laundry have policies and procedures for cleaning and maintaining the plant and its equipment? Does everything appear clean and free of lint? Look on the walls, tables, ceilings, and under equipment. 3) How does the laundry handle waste? Ask for an explanation of their policy for managing medical waste and hazardous substance-related wastes. 4) Is the provider in compliance with relevant regulations regarding air, water, wastewater, and chemicals? 5) What’s the backup plan for providing uninterrupted operations and services? Does the provider have reciprocal processing agreement in place in the event of a disaster? 6) Stuff shouldn’t happen: How does the provider ensure and maintain the proper functioning of the plant’s equipment? Ask to see the equipment maintenance log to ensure that maintenance is&nbsp;being followed. The Personnel 7) Are the employees—at all levels—focused on patient safety and service quality? Speak to the laundry personnel to learn as much as you can about the plant culture. 8) Do you get a sense of professionalism? How does the provider ensure and document that personnel are qualified for their respective positions, and are job descriptions clearly defined? 9) What if someone comes to work sick? What are the health and hygiene policies and procedures to prevent textiles from being handled by or exposure to personnel with potential health issues? 10) Informational signage should be everywhere. For example, regarding the handling of chemicals, is safety information and signage readily accessible to personnel? Are contaminated linen areas clearly marked? 11) What are the procedures when personnel are exposed to hazards (e.g., biological, chemical, mechanical, etc.)? Ask employees for an explanation of those procedures. 12) What are the hand-washing and hand-hygiene procedures? 13) Are all personnel protected adequately? What are the provisions and procedures for personal protective equipment (PPE) and attire? Observe&nbsp;workers in areas exposed to soiled linen (washers, sorters, drivers). Are they wearing appropriate PPE? 14) Is there a program addressing occupational safety and health (e.g., exposure control plans, etc.)? 15) What about continued training? What programs exist for continued education regarding safety, laundry operations, pack processes, and other processes, Bloodborne Pathogens Exposure Control Training, etc.? 16) Note: HLAC’s current standard’s manual devotes an entire section that addresses facility and process elements unique to the presence of surgical pack assembly. The Process 17) What is the facility’s procedures and policies regarding the handling and collection of soiled health care textiles? Are these in accordance with relevant regulations? 18) Functional separation is key to the process: How does the provider maintain and ensure the separation of clean textiles from soiled textiles? This applies to carts, sort/wash/dry/finish areas and/or vehicles during handling, collection, and transportation of soiled textiles. 19) Likewise, what are the provider’s procedures regarding cleaning and disinfecting in the use of carts, containers, covers, and liners to collect and transport&nbsp;soiled textiles? Visually inspect their clean carts—are they free of visible soil on the outside and inside? 20) What are the precautions in place in the soiled sorting area? 21) Finding foreign objects in linens is a common occurrence. What are the provider’s policies regarding these (e.g., reusable surgical instruments, sharps, etc.)? 22) What are the provider’s processes regarding washing and extraction? Ask to see a titration report. Look for appropriate contact time, wash temperatures, and chemical concentrations 23) How does the provider ensure that washed health care textiles become hygienically clean? 24) Make sure you get a full understanding of the provider’s extracting and drying procedures to preserve the integrity of textiles, and to minimize microbial growth after washing and prepare for ironing and folding. 25) What are the processes in place regarding drying, finishing, folding, stacking, packaging, storage, and transport? Lastly, while not part of the Three Ps per se, it’s also smart to check references for a complete picture of how the provider performs on a continuing basis relative to its standards. Sun, 29 Nov 2015 10:30:57 -0600 Operations Related to Textile Management Partners in Textile Hygiene /partners-textile-hygiene <h1>Partners in Textile Hygiene</h1> <h4>By Chad Basham, MBA, CHESP, Nellie League, MSN, RN, NE-BC, and Lynn Moreau, BSN, RN</h4> November 29, 2015&nbsp;|&nbsp;Formats:&nbsp;Article&nbsp;|&nbsp;Content Areas:&nbsp;Environmental Sanitation Operations, Textile Management Operations&nbsp;|&nbsp;Tags:&nbsp;Beds, Disaster/Outbreak Preparedness, Emerging Pathogens, Environmental hygiene and sanitation, Infection Prevention and Epidemiology, Laundry and Textiles, Linen , Patient Experience of Care <hr /> Good relationships and working as a team make crises or events more manageable. Chad Basham, MBA, CHESP, administrative director of Environmental Services, and Nellie League, MSN, RN, NE-BC, chief nurse executive/VP, both of Bon Secours St. Mary’s Hospital in Richmond, VA, and Lynn Moreau, BSN, RN, clinical liaison manager, HandCraft Linen Services, recently shared their thoughts behind this statement at EXCHANGE 2015. During their session on Wednesday, Sept. 23, “Environmental Services, Infection Prevention, and Health Care Laundry: Partners in Textile Hygiene,” they detailed how St. Mary’s (a 391-licensed bed, not-for-profit hospital) partnered with its laundry provider to enhance management practices. The goal was to focus on teamwork and involving the individuals who have the greatest impact on textile hygiene and safe linen distribution and storage. The Mucormycosis Fungus Scare In spring 2014, national news revealed that back in 2009, linens at New Orleans Children’s Hospital (NOCH) had been contaminated with the fungus mucormycosis. Per the Centers for Disease Control and Prevention (CDC), five case-patients had hospital-associated cutaneous (skin) mucormycosis over an 11-month period, and all subsequently died. A May 2014&nbsp;article in the Pediatric Infectious Disease Journal raised concerns about NOCH’s response to the outbreak. The New York Times highlighted the journal’s report citing “lapses in the hospital’s infection controls and sloppy handling of contaminated linens.” The Times also reported that “workers unloaded clean linens on the same dock where medical waste was removed, moved clean and soiled linens on the same carts, and stored linens in hospital hallways covered in dust from a nearby construction site.” The CDC and Louisiana State Health Department found the mucormycosis occurred on several different units throughout the hospital, and hospital linens were the only exposure identified as common to the case-patients. So, what next? HandCraft, St. Mary’s laundry partner, took this news seriously and wanted to make sure its health care linen customers did as well. Realizing there were opportunities for St. Mary’s to enhance linen stewardship and awareness, it involved all levels of environmental services and clinical staff in a linen stewardship program in partnership with their laundry provider. This included rounds, educational handouts, quiz contests, and tours of the provider’s laundry facilities. Soon, everyone involved realized that teamwork between the hospital and laundry provider yielded greater linen stewardship and accountability. The NOCH Response: HandCraft’s Strategy The strategy involved four components: communication, validation, education, and collaboration. <ol> <li>Communication: The goal was to ensure HandCraft management, sales teams, and hospital customer service representatives all knew the facts surrounding the circumstances at NOCH.</li> <li>Validation: HandCraft reviewed and evaluated current operations practices within its laundry to ensure they were consistent with the laundry industry’s best practices.</li> <li>Education: This was an opportunity to review and reinforce infection prevention principles and hand hygiene emphasis in plant operations.</li> <li>Collaboration: Last but not least, HandCraft wanted to enhance partnerships with its customers. They used this opportunity to educate about NOCH and ensure hospitals clearly understood best practices for handling and storage of clean and soiled linen.</li> </ol> HandCraft made rounds in its hospitals to assist in evaluating hospital procedures and linen rooms. Environmental services, infection preventionists (IPs), and nursing executives/management were involved as much as possible. Some hospitals enhanced cleaning procedures of linen rooms and&nbsp;linen storage areas. Challenges included hospital staff properly filling and securely tying soiled linen bags, but handouts and education rounds helped improve soiled linen collection processes. HandCraft focused on seven key laundry functions to ensure hygienically clean linen: <ol> <li>Proper collecting and sorting contaminated hospital textiles.</li> <li>Proper transporting of contaminated hospital textiles.</li> <li>Maintaining division of clean and soiled areas in the laundry.</li> <li>Appropriate sorting, laundering, drying, and ironing of hospital textiles.</li> <li>Proper transport and storage of clean hospital textiles.</li> <li>Cleaning and disinfection of the plant and transportation fleet.</li> <li>Hygienic handling of linen by staff during production and distribution.</li> </ol> The NOCH Response: St. Mary’s Strategy The St. Mary’s team took a similar strategic approach to the NOCH event using the same four components: communication, validation, education, and collaboration. <ol> <li>Communication: The hospital shared the story of NOCH events with its staff. Many had not heard of the unfortunate circumstances at NOCH.</li> <li>Validation: Current infection prevention practices within the hospital were reviewed to ensure they were consistent with evidence-based best practices for health care linen. A collaborative inspection of the linen room revealed an opportunity to reconfigure it, resulting in a designated clean linen storage area and soiled linen storage area. Environmental services set up a routine cleaning schedule for those areas as well.</li> <li>Education: St. Mary’s, like HandCraft, used this opportunity to reinforce infection prevention guidelines and hand hygiene throughout the hospital.</li> <li>Collaboration: In partnering with its laundry provider, St. Mary’s used that collaborative effort to review best practices, make some needed changes, and acknowledge staff who were instrumental in the process.</li> </ol> St. Mary’s stressed five key best linen practices in the hospital: <ol> <li>Separation during storage of clean and soiled linen.</li> <li>Keep linen covered at all times.</li> <li>Secure access to clean linen.</li> <li>Use proper hand hygiene when touching clean linen and when removing soiled.</li> <li>Keep the linen room clean from top to bottom.</li> </ol> Well-Prepared for Ebola Collaborative efforts came just in time for the next crisis: the Ebola events in the fall 2014. At HandCraft, the NOCH response had created templates for activity regarding Ebola. HandCraft sent a customer-wide email to environmental services directors and IPs asking for a collaborative approach. St. Mary’s formed an interdisciplinary team to develop policies and procedures regarding potential Ebola patients. Management joined multiple CDC conference calls as the agency developed a response and identified best practices. Additionally, the hospital consulted with community partners, the state health department, and other acute care hospitals. CDC recommendations for linen in contact with a confirmed Ebola patient were followed, and a policy was developed to discard (incinerate) all linen in contact with an Ebola patient to reduce exposure to potentially contaminated textiles among staff. Laundry Accreditation and Standards Linens have long been recognized as fomites but almost never viewed as an HAI risk due to effective pathogen removal when best laundry practices are applied and correct handling, collection, and storage is applied. Hospitals should be knowledgeable regarding whether their contract laundries are accredited and/or certified. Laundry accreditation through HLAC (Healthcare Laundry Accrediting Council) is based on the highest standards for patient safety and infection prevention. This accreditation’s principle benefit is inspection by an independent third party to ensure the highest standards of processing. Hygienically Clean Certification through TRSA (Textile Rental Services Association) validates laundries’ processes, verifying their commitment to cleanliness through third-party inspection and quantified biological testing, and using USP 62 protocol and RODAC testing. Both HLAC accreditation and Hygienically Clean Certification are voluntary processes for health care laundries. Keeping the Focus on the Patient Past infection prevention challenges, such as NOCH and Ebola, should not be misconstrued. Everyday concerns, as well as these headline-makers, drive practices. We’re concerned about measles resurgence in the U.S., Legionnaire’s disease, listeria outbreaks, and contaminated endoscopes. Continuous preparedness, maintaining best practices, and teamwork create a “win-win,” but the true winner is the patient. After all, it’s all about the patient. Sun, 29 Nov 2015 10:06:30 -0600 Operations Related to Textile Management