A demand for nursing home laundry operations
James M. Berklan
It took a while, but the tentacles of a deadly fungal infection at a New Orleans children's hospital might wind up affecting the other end of healthcare's aging spectrum: nursing homes.
Linens, towels and gowns have been identified by researchers as the likely carriers of the deadly fungus mucormycosis. As a result, the head of the Healthcare Laundry Accreditation Council (HLAC) has called for a consensus on laundry processing standards.
“Hospitals, nursing homes and all healthcare facilities should demand it,” said Gregory Gicewicz, president of HLAC.
Gicewicz's Sterile Surgical Systems firm processes laundry for nursing homes and other healthcare facilities around its Tumwater, WA, base. It is one of more than 200 entities now accredited by HLAC.
“There are millions of standards out there, but the problems is there are lots of different standards from different groups,” Gicewicz told me Tuesday. “We've put together standards — more than 600 of them — based on all of these organizations that have standards or laws.”
He likens the process to a provider seeking Joint Commission accreditation.
“It's kind of up to the hospital or long-term care facility to monitor that it's being done correctly. If you're accredited by HLAC, it's a pretty good sign it [laundry] is being done accurately and correctly."
It also could mean the difference between life and death, Gicewicz pointed out. In 2008 and 2009, five children who were at Children's Hospital in New Orleans succumbed to complications from mucormycosis.
The culprit was identified only in this month's edition of the Pediatric Infectious Disease Journal, which ran a report called “Mucormycosis Outbreak Associated with Hospital Linens.” Shoddy transport of clean linens and possibly other items led to the infections that killed the children. The cases mysteriously unfolded months apart from one another, making it tougher to connect the dots.
“It's essential to make sure clean textiles are separated from those that are not. Many, many times this is not happening,” warned Gicewicz. “In many places, there's something going in the washer, right next to something coming out that's cleaned. Does that mean there's always a huge illness or sickness or death coming out of that? Probably not, but I would want to be assured that's not happening.”
Since 2005, HLAC has been in the business of sending inspection teams into facilities to address any shortcomings and help correct them. The tab is $5,000, and that doesn't include any corrective steps that are assigned. The accreditation team makes a one-day visit and an approval rating lasts for three years.
“I'm a small owner-operator and I wouldn't dream of not going through this process. It's credibility to my customers,” Gicewicz explained. “It made our people more educated and made us safer. It brought us to another level of expertise and credibility. It's just assurance for patient or resident safety.”
Most of HLAC's accredited providers are hospitals, its president acknowledged, and most of those are contracted services (not on-site laundry operations). But that can change quickly — there hasn't been much direct outreach to long-term care yet, Gicewicz pointed out.
The accreditation team represents a wide range of stakeholders, he explained. It includes professionals with government agency experience, infection control nurse specialists, and laundry-service providers.
But HLAC accreditation is not simply a bunch of vendors trying to stir up more business, he emphasized. It's actually the infection-control nursing experts and former government employees who want the standards to say “everything has to be completely sterile and it takes about 8 gazillion dollars to make sure the laundry is completely in a clean room and other completely unrealistic goals,” he said. The owners-operators are less rigid and are willing to speak up when they think suggested policies might be “overkill.”
“For better or worse, the tragedy that happened in New Orleans is going to drive a lot of awareness,” Gicewicz noted. “We're seeing more and more hospitals insisting on accredited organizations to do their linens.”
James M. Berklan is McKnight's Editor. Follow him @LTCEditorsDesk.