No one in a healthcare or hospitality facility likes to see a blood stain on a white bed sheet, but stains happen. They are both frequent and diverse. And overall, blood and other biological stains are the most common. 

In hospitals, betadine antiseptics and medicines stain sheets. In hotels, coffee, tea and chocolates stain the sheets. Extended stay facilities, particularly those with kitchenettes, are subject to a wide assortment of chemicals and organic compounds leaving their marks on terry products. While some stains are permanent, many facilities have problems with employees discarding linens with stains that actually can be removed.

“A lot of people (including nurses and housekeepers) think if there’s blood on something, it’s a biohazard and must be disposed of in a biohazard bag, but that is not always the case,” says John Scherberger, a certified healthcare environmental services professional and registered executive housekeeper, as well as a board member of the Healthcare Laundry Accreditation Council.

Custodial managers must have policies and procedures in place to address blood-stained textiles. The alternative is increased costs in replacing linens.

“Too many people think that if they couldn’t get a specific stain out at home, the same will be true at work, so they throw the linen away – and that’s not right,” Scherberger said.

The decision to discard soiled linen or textiles should be left to the quality control professionals in the laundry room.

Even if a pillow case, for example, has a tear beyond repair, it should be sent to laundry for inventory. There, a record can be made noting whether a loss is due to theft, patron damage, housekeeping damage or laundry damage.

A facility with on-site laundry should designate someone on staff to handle quality control. This person assigned as the quality controller should understand the capabilities of commercial laundry processes so they can identify which linens can stay and what needs to go.

Of course, sometimes linens or textiles will slip through quality control. When they do, the custodial staff should sort those items with stains or holes in a bag of a specific color and send them back to laundry for inventory.

“When you have good quality control, you save money,” Scherberger said.

Without good quality control, housekeepers take longer to make the beds, because they have to pull off damaged or stained sheets. If they don’t, a patient or guest may see the stain — and that’s a bigger problem.


The Red Bag Initiative

The Association for Linen Management reports hospitals err on the side of caution and train staff to dispose of contaminated linen as red bag waste, assuming it cannot be cleaned.

Members of both ALM and American Reusable Textile Association estimate that, annually, as much as 25 percent of their linen exits client locations as red bag waste. To dispose of this “waste,” ALM reports hospitals pay 18 to 33 cents per pound, and the problem is compounded by the cost of replacing the discarded linen.

ALM and ARTA are working to educate their members and healthcare clients on correct and less costly methods for handling contaminated linen.

The reality is that the greater majority of healthcare laundry processors utilize Universal Precautions (the use of personal protective equipment) for all textiles entering the laundry processing facility. When this is the case, it is not necessary to place blood-saturated linen in red bags. By doing so, the laundry personnel will assume that the bag contains biohazardous waste and has been sent to the laundry in error. 

The Exception
If the laundry is sorted in a way that distinguishes “soiled” laundry (that which is simply dirty) from “contaminated” laundry (that which has been exposed to blood or other potentially infectious material), only then does OSHA require the “contaminated” laundry to be identified as different from the “soiled” laundry.

In this situation, a red bag is not required (it is an option). The hospital/clinic may substitute the red/orange biohazard label on the textile bag to indicate that Bloodborne Pathogen Requirements are necessary for handling this bag. n

SOURCE: Association for Linen Management

Healthcare Laundry Accreditation Council
American Reusable Textile Association

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