Laundry practices deserve a bigger role in COVID-19 prevention strategies for nursing homes and senior living communities, caution experts in the field.

It’s an area that’s relatively overlooked in the eldercare industry, volunteer board members from the nonprofit Healthcare Laundry Accreditation Council told McKnight’s. But with operators under enormous scrutiny during the pandemic, and most handling laundry on site, it may be time to consider additional attention to practices, they said.

In visits to skilled nursing facilities and senior living communities, HLAC Board President Linda McCurdy has long noted a lack of infection control protocol when it comes to laundry services. “Not only HLAC processes, but [the Centers for Disease Control and Prevention] and Health Canada standard operating procedures aren’t being followed,” said McCurdy, president and CEO of K-Bro Linen Systems in Canada and a veteran of the healthcare laundry processing industry.

“I think that’s a problem,” concurred Gregory Gicewicz, past HLAC board president and president/owner of Sterile Surgical Systems in Washington state. “We don’t see the same levels of rigor and same adherence to standards in the long-term care facilities that we do in the acute-care facilities.”

Meeting standards may be even more critical when residents’ health already is compromised, Gicewicz added. Although it is rare that infections and deaths are traced conclusively to linen, a few high-profile cases have occurred in healthcare institutions, notably involving immunocompromised or otherwise at-risk individuals, he said. 

Organisms such as Clostridium difficile may be on the linen, for example. If it is not laundered properly or if C-diff contaminated linen touches clean linen, it may be transmitted to staff involved in handling soiled items, opening up the opportunity to infect residents. COVID-19 has been found to last two days or more on linens. Improper processes, such incorrect water temperatures and handling procedures, can increase the risk of disease transmission. 

The takeaway? It’s all about the process, McCurdy and Gicewicz said. If staff members get the steps right, then they will end up with hygienically clean laundry. If not, there may be problems, they said.

Common misses:

  • Lack of functional separation: It is “absolutely imperative” that clean, processed linen is kept functionally separate from dirty, contaminated linen to avoid cross-contamination, McCurdy said.
  • Mixing heavily and lightly soiled items: Items heavily soiled with bodily fluids (such as incontinence pads) must not be mixed with lightly soiled items (such as a bedspread). Many facilities, when asked to show their policy for sorting details, assume that simply ensuring that everything is washed means that it is clean, but this isn’t true in practice, Gicewicz cautioned.
  • Negative air flow: Often, no wall or physical structure exists in an eldercare facility’s laundry to prevent air where dirty laundry is handled from flowing to the area where the clean laundry is handled, increasing the risk of contamination.

No matter how an operator decides to tackle the question of improving laundry processes, awareness of the risks and potential problems must be the top concern, Gicewicz concluded.