SOP for Hospital Laundry

ABC HOSPITAL

LAUNDRY DEPARTMENT

INDEX
1. OPERATING PHILOSOPHY
2. AIMS & OBJECTIVES
3. WORKING PRINCIPLES
4. FUNCTIONS
5. WORK FLOW
6. ORGANIZATION STRUCTURE
7. INTERFACE WITH OTHER DEPARTMENT
8. LAYOUT
9. STANDARD OPERATING PROCEDURES
10. DRESS CODE
OPERATING PHILOSOPHY
The operating philosophy of the Central Sterile Supply Department would be in conformance with the goals and objectives of ABC Hospital i.e. Excellence in patient care, Excellence in clinical care and Excellence in service. The path leading to achieve these objectives would be to have a participative approach and process oriented way of thinking and developing systems that assure continuous improvement involving people at all levels so that quality service is provided to the patients on a continued basis with high reliability and reproducibility.
Not a day should pass by without some kind of improvement being made somewhere in the system. The focus should be on improved quality, prompt delivery, lower costs, lower inventory, compressed cycle time, profitability and effective and responsible organizational system.
AIM: The aim of the Laundry Department is to provide all the hospital departments served, adequate supply of clean linen conforming to highest standards of cleanliness and hygiene immediately and constantly available for routine and emergency use from a central place thus reducing the overall cost and contributing towards the efficient and effective supply of linen to all Hospital Departments.

OBJECTIVES:
The objectives of the Laundry Department are as follows:
1. To provide linen free of dirt, soils and stains to all User Departments.
2. To monitor and enforce controls necessary to prevent spoilage (wear & tear due to washing) of linen and reduce the frequency of linen turn over by increasing their life period.
3. To maintain record of effectiveness of cleaning, disinfecting and turnover.
4. To stay updated regarding developments in the field in the interest of efficiency, economy, accuracy and provision of better patient care.
5. To undertake studies for improvement of clean practices and processing methods to provide supplies economically.
6. To develop a cost effective program by cost analysis of personnel, supplies and equipment.

WORKING PRINCIPLES
1. RESPONSIBILITY
The first basic principle is that the responsibility of the supervision of routine cleaning, collection and distribution tasks should be clearly defined, clearly understood and undivided.
2. UNIDIRECTIONAL WORK FLOW
There are three categories of dirty linen to be dealt with in Laundry. Soiled items that are drenched with faecal matter, Urine and Blood stains. Stained items due to stains from some injections that can be removed only through bleaching and caustic soda. Dirty linen with normal dirts and dusts. It is safe to consider all used items as contaminated. The term clean supply covers all articles, which have been washed, pressed and ready for the User Departments for further processes of sterilization and usage. It is important that unidirectional flow of activities is followed and all steps should be taken to avoid mixing up of contaminated and clean articles at any stage of processing or transportation.
3. CONTAMINATED LINEN TO BE TRANSPORTED SEPARATE FROM CLEAN SUPPLIES
In accordance with the second principle stated above, never should clean supplies and contaminated articles be carried on same trolleys at the same time as there is a real risk that the two may get mixed up. No persons undertaking delivery can be supervised. There will always be pressure to allow staff delivering clean linen to collect contaminated articles at the same time. It reduces the number of journeys if they do so. Such pressures should be resisted and delivery always kept from collection. Separate rounds one for delivery and another for collection should be insisted upon.
FUNCTIONS OF LAUNDRY DEPARTMENT
Functional flow of activities in Laundry shall be specified as follows:
1. RECEIPT OF ARTICLES: To receive used and dirty linen from various user departments like operation theaters, ICUs, emergency, IPD, OPD and radiology etc.
2. CLEANING & DISINFECTION: All reusable linen are thoroughly cleaned with bleaching powder/ caustic soda and disinfected using disinfectants depending upon the type of soil and its to the compatibility with the linen.
3. INSPECTION AND ASSEMBLY: Each item to be washed is inspected for wear & tears, defects, stains and then appropriately put in the washing machine. After washing, the linen is drained of for excess water using water extractor and dried in drier before assembling for press in the pressing machine. The operation of the machines shall be entrusted to responsible and fully trained person. It should be kept in a state of good maintenance and repair.
4. CLEAN STORAGE: clean and contaminated supplies are stored separately. Clean storage environment is designed primarily to prevent contamination of Clean Linen.
5. DISTRIBUTION: Refers to distribution of clean goods to the patient care areas.
USER DEPARTMENTS
OT, IPD, OPD, Support, Casualty

STORE Receipt of ENGINEERING
Dirty linen


Consumables Preventive Maintenance
LAUNDRY

SORTING OF
DIRTY LINEN

SOILED STAINED NORMAL

Dip & Rub in Bleach/
Caustic Soda/ Stain Removers

WASHING MACHINE
(Preferred Hot Water)

WATER EXTRACTOR

DRYER

Remove & send torn
clothes for tailoring STEAM
FOLD &
PRESS

DISTRIBUTION TO
USER DEPARTMENTS
LAYOUT OF LAUNDRY

The layout of the Laundry should be done in such a way that there is a unidirectional flow of materials so that mixing up of the dirty linen and clean line is avoided.

· Reception and Sorting Area
· Scrub Area for Soiled and Stained Linen
· Machine Area (for Washing, Water Extracting and Dryers)
· Sorting Table for torn Clothes.
· Press Machine
· Clean Storage and Tailoring Room

In Laundry, the importance is given mainly to the Storage Area.

Storage Area

SURFACES:
The walls, ceilings, floors and work surfaces should:
Not have difficult to clean corners and crevices;
Be made of non-porous, smooth, easily cleaned and maintained materials.

TEMPERATURE AND HUMIDITY
Temperature range approximately 22-27 degree C
A relative humidity range of 35-75%

ACCESS TO PERSONNEL
Access should be limited to personnel who:
are authorized to be in the area.
are free of communicable diseases and observe good personnel hygiene.
are wearing freshly laundered attire provided by the hospital.

STORAGE SYSTEM
The storage system should be designed as to:
Enable items to be stored at least 8 inches from the floor, 2 inches from the outside walls and at least 18 inches from ceiling fixtures.
Minimum dust collection on the material.
Have enough space between storage units.
Receipt of Dirty Linen
The Linen inventory shall be maintained in the wards itself by the respective Sister Incharges with a copy of it in the Materials Management and Laundry.

Every morning, the Laundry attendant will go to different wards, O.T, O.P.D and collect the dirty linen. It is preferred that the trolley has different chambers for soiled and normal dirty linen. Whenever the attendant collects the linen, it has to be clearly mentioned about the different linen and quantity along with the signature of the Sister I/C. A separate register has to be maintained in different wards for the same.

Each linen should have an identity of its own. The proposed identity for the Linen is as follows:

· Name of the Organisation : ABC Hospital
· Name or No. of the Ward/ Room : Ortho II or 6
· Name of the Material : BS (Bedsheet), PG (Patient Gown), DS (Draw
Sheet), PC (Pillow Case), etc,.
· Number of the Linen : 1 to …..

Example ABC Hospital/13/BS/25 or ABC Hospital/Ped/BS/25 refers to the bedsheet belonging to paediatric Ward and it is 25th bedsheet among Hundreds.

This system can enhance the inventory management and avoid loss of inventory.

Sorting of Linen
The linen after collected from the different wards has to be sorted out in the Laundry. The Soiled, stained and normal dirty linen have to be sorted out.

Removal of Soils/ Stains
It is recommended that 4 gms of bleaching powder for every litre of hot water(20 – 43 C) and dipping the clothes for atleast 20 minutes is recommended for removal of Soils and stains. If necessary rubbing the stain area should also be done to remove strong stains & soils. Now a days, good stain removing detergents are available in market itself.

The persons handling the soiled/stained linen should use a thick rubber gloves that can tolerate Bleach and Luke Warm water.

Washing
Hot water (20 – 43 C) is recommended for using in washing machines. This can act as an disinfecting agent too. The time of linen in the washing machine depends on different types of linen. Usually it is recommended for 30 minutes n the mode of strong wash.

Water Extractors & Dryers
The washed linen is put in the water extractors for 3 – 5 minutes and then sent to dryers for drying.

Sorting of torn linen for tailoring
After drying, the linen is checked for wear and tears. The torn clothes should be sent for mending/ tailoring. If the linen is out of the scope of mending, then the condemnation committee should condemn it.

The Condemnation Committee should consist of the following members.
1. Laundry Supervisor
2. Tailor
3. Store Officer
4. Responsible person from the User Department.

Separate register has to be maintained for the condemnation materials and record has to be kept for the replaced materials, which can help us in knowing the linen turn over.

Folding and Pressing
A pressing machine that can generate its own steam is recommended. This can help in saving the electricity and wastage of steam while traveling a long distance. Now a days, the systems that are self dependent are preferred to save the costs.

Distribution
The finished goods are to be stored in the clean storage area before distribution. The clean linen should be checked for quantity before delivery. Then the linen should be distributed to different Departments in a separate trolley which are not used for collection. The receipt vouchers that were used during collection should be checked and signed again by the Sister Incharge while getting back the clean linen from the Laundry.

RECORD KEEPING
Following records shall be maintained for all instruments processed in CSSD:
a) Dispatch record
b) Receipt record
c) Storage record.

Following documents should be maintained:
1. Instruction manual for all the equipment.
2. Records of all preventive maintenance, calibration and repairs of equipment.
3. Load Records including contents of each load, initials of the operator, equipment number or other identification and the date and time of cycle.
ORGANISATION STRUCTURE

Medical Superintendent
EXECUTIVE LAUNDRY

(1) Laundry Technician

(5) (Unskilled)

CRITERIA FOR MANPOWER SELECTION
1. LAUNDRY OPERATOR TECHNICIAN
10+2 or Graduate
Preferred: Diploma in Laundry Techniques
Experience: 5 years

2. UNSKILLED - 10
DRESS CODE

STANDARD ATTIRE
1. The uniform MUST NOT be worn out side the hospital.
2. Uniform shall consist of clean scrub attire, provided by the hospital.
3. Head covering – caps shall be worn, completely covering the hair.
4. Jewellery – wearing of jewellery is discouraged, due to contact with chemicals.

SPECIAL ATTIRE
1. Shoe Covers: shall be worn while working in the Laundry.
2. Gowns: which covers arms shall be worn by all while working in the decontamination area, linen and packing area.
3. Gloves: Shall be worn while working in any section.
4. Masks: Shall be worn by all.

Exceptions:
1. Clerical / Supervisory Staff: Shall wear ordinary clothes covered with a clean lab coat.
2. Visitors: Shall wear a cover