'Big' laundry challenges persist

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Sandy Fredrickson is like a lot of long-term care laundry managers. She figures her facility's equipment is fine. It's the human element she has to keep an eye on, particularly when it comes to infection control and various cleanliness issues.

"One of the biggest challenges laundry services face right now is the MRSE issue and dealing with that," she said, referring to the defeat of certain antibiotic-resistant organisms. "Using universal precautions should be safe enough. No extra procedures need to be done.

"But the staff becomes frightened when they hear the terms," she explained. "It would be kind of the same way as it was years ago when AIDs started up. It takes education to get the staff to deal with these issues, to be careful with it."

She said wearing basic protective garments and gloves while following standard sorting and transferring protocols should be enough. Yet the human element is bound to create stumbling blocks in other ways, she noted.

She should know. She's a 28-year veteran in this field and currently the environmental services director at Albert Lea Good Samaritan Center, a 182-bed nursing facility that also has assisted living units in Albert Lea, MN.

Handling problems

Fredrickson knows where some of her biggest problems start: before material ever arrives in the laundry room.

"Sometimes (nursing) staff gets really busy. The laundry, if it has body excretion in it, is supposed be rinsed out near the room, close to the pick-up area," she explained. "Sometimes that gets missed and gets sent down to the laundry. We do have some problems there."

As a result, laundry staff have to invest more time in cleaning dirtier laundry properly, or use more resources to do extra washings.

Worse, odors can get embedded if extremely soiled materials go unaddressed for too long.

When you're handling 22 tons of laundry a month, as Fredrickson's crew does, that's a lot of extra resources at stake.

Frank Galie, her counterpart at Normandy Farms Estates in Bluebell, PA, said his biggest problem also stems from human miscues.

"The only issue of concern out of the skilled-nursing area for laundry is the over utilization of washcloths," Galie said. "When they (nurses) do a bed changing, they just throw them away. They're supposed to wash them in a utility room and then put them in a bag to go to the laundry, but it doesn't happen. I have to buy 40 dozen wash cloths each quarter."

Galie's other big irritant also involves human error: unmarked personal clothing.

"They should all be marked, but they aren't," Galie said. As a result, nursing aides may wind up returning clothes to the wrong room. The laundry room, naturally, is unfairly criticized, he said.

Top managers also need to keep in mind that laundry operations and other support services might need more space, or upgrades, accommodate rising resident populations when new buildings or wings are added.

Consistent performers

Due to increased automation and computerization of everything from chemical dispensing to cycle times, the actual cleaning and disinfecting process is actually quite efficient, says Sam Garafalo, a Syracuse, NY-based industry consultant. A 50-year veteran in institutional laundry matters, Garafalo's Technical Consulting clients process 135 million pounds of laundry each week.

"If there's room for improvement, it's in the material handling," Garafalo said. "All procedures in an on-premise laundry should follow the Bloodborne Pathogens Rule, which says everything soiled should be treated as a biohazard. That means taking what's called universal precautions. But nursing home owners don't want to do that. They don't want to think they have to follow procedure, but they really should. We have implications for OSHA (Occupational Safety and Health Administration) here, too."

Common mistakes that persist, he said, include distributing clean laundry with a cart that was used for gathering dirty materials, and workers loading washers and unloading washers without washing their hands or changing gloves.

Facilities with 150 or fewer beds seem to have the most operational failur