Hospital laundry, often overlooked, is a vital part of infection prevention. Contaminated linen from wards, ICUs, OTs and isolation areas requires proper handling, washing and transport to prevent clean linen from spreading infections. Writing for Clean India Journal, Madan Mohan Singh Bisht, Senior Manager Laundry at Regency Hospital Ltd, Kanpur, highlights the challenges involved in maintaining linen hygiene and ensuring patient safety
In a hospital, the laundry department is one of the most critical yet underappreciated components of infection control. Linen from every corner of the facility be it ward, ICU, operating theatre (OT) and emergency unit, passes through the laundry before being reused. If not processed correctly, contaminated linen can become an infection-spreading vehicle.
Error Free
Hospital laundries operate under strict Standard Operating Procedures (SOPs), and adherence to these protocols is non-negotiable. Errors can occur for several reasons like staff shortages, excessive workloads, inadequate machinery, lack of supervision, or attempts to save time by skipping wash programmes or altering temperature settings. Even a minor mistake can become a major risk for the next patient who uses that linen.
However, contamination risks do not always originate within the laundry itself. Support staff responsible for collecting and delivering linen can unintentionally compromise hygiene standards. For instance, using the same basket to transport soiled linen and freshly washed linen can lead to cross-contamination.
Handling Risks
The risk of contamination does not end once linen has been washed. Improper handling and transportation can reintroduce contaminants, particularly when hospitals outsource laundry operations. In an in-house laundry, the hospital’s quality control team can conduct surprise inspections and monitor hygiene practices regularly. With outsourced laundries, hospitals often have limited scope to check their daily operations.
Questions often arise regarding adherence to SOPs, vehicle cleanliness and overall hygiene standards during transportation. Although concerns exist, tracing a hospital-acquired infection directly to contaminated linen remains difficult. We rarely come to know whether a specific infection originated from linen.
“A minor mistake in washing can become a major risk for the next patient who uses that linen”— Madan Mohan Singh Bisht Senior Manager Laundry at Regency Hospital Ltd, Kanpur
Temperature Test
Temperature control is one of the most important elements of hospital laundry hygiene. The ideal washing temperature for hospital linen is 70°C. At this temperature, viruses, fungi, germs and bacteria are effectively eliminated. Maintaining this temperature consistently throughout the wash cycle forms the foundation of effective linen disinfection.
Training Module
Technology and processes alone cannot guarantee hygiene. Well-trained staff play an equally important role. All laundry personnel at Regency Hospital undergo regular training on hygiene protocols. Daily morning briefings are conducted, and staff members displaying symptoms of illness, such as coughs or colds, are advised to take leave. This ensures that only healthy personnel handle hospital linen.
Challenges
While outsourcing can reduce operational burdens, it may also create quality-control challenges.
Hospitals often have limited knowledge about the chemicals/solutions used by third-party laundries or whether prescribed dosages are being maintained. Cost-cutting measures can sometimes lead to diluted chemicals, reduced wash quality or deviations from the established SOPs. There is always a concern about whether all SOPs are being followed as rigorously as they should be.
Automation Advantage
Regency Hospital currently operates a fully automated laundry facility for its 500-bed hospital and is preparing for an additional 350 beds in the near future. In an automated system, dirty linen is loaded into the machine and passes through every stage of the process automatically. There is no scope for skipping programmes or altering settings midway.
Automation not only improves efficiency but also reduces human intervention, thereby minimising the possibility of errors and ensuring consistent hygiene standards.
Different Plans
Not all hospital linen is treated the same way. Operating Theatre (OT) linen undergoes the most rigorous processing because it serves as a sterile barrier during surgical procedures and is frequently exposed to blood and other high-risk contaminants. After segregation and specialised washing, OT linen is mandatorily sterilised through autoclaving. Green-coloured linen is typically used in OTs.
On the other hand, ICU linen often requires extensive pre-treatment. Heavily soiled items may undergo sluicing or multiple pre-wash cycles (up to 5 rinses) before entering the standard laundering process.
ICU linen can be pre-washed several times before the actual laundry cycle begins. Staff handling such linen must wear full PPE because of the higher contamination risk. Following pre-treatment, the linen undergoes temperature-controlled washing and thermal disinfection.
Linen Inventory
Unlike some hospitals that use RFID-enabled tracking systems, Regency Hospital manages its linen inventory manually. The hospital experiences an average linen loss of 3-4% and follows a monthly procurement schedule. For its 500-bed capacity, approximately 800 bedsheets and 1,000 metres of OT fabric are procured every month.
Discarding Plan
Hospital linen is not discarded immediately at the first sign of wear and tear. Minor damage is repaired through stitching, while moderately damaged linen is repurposed as dusters. Linen that is heavily damaged or no longer suitable for hospital use is disposed of through complete destruction (read burnt) as per hospital policy.
Infection Control
Hospital laundry operations may remain hidden from public view, but they play a vital role in patient safety. From maintaining precise washing temperatures and ensuring proper segregation to preventing cross-contamination during handling and transport, every step matters.
The difference between contaminated and clean linen often comes down to disciplined processes, trained personnel and unwavering attention to detail — factors that make hospital laundry one of the most important yet underestimated pillars of infection prevention.