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«Policy Number IC01 Policy Title INFECTION PREVENTION AND CONTROL POLICY Accountable Director Director of Infection Prevention and Control Author Lead ...»

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Linen Rooms should be easily cleanable. Cupboards and mobile storage units should be equipped with shelving that can be easily cleaned and allow the free movement of air around stored linen. Linen must be stored above floor level approximately 30cm to enable easy access for cleaning, away from direct sunlight and water in a secure dry and cool environment. The area must always be kept clean and tidy. Cleaning frequencies should be agreed locally and recorded on the cleaning schedule. Linen stocks should be temporarily removed annually to facilitate thorough cleaning of the storage area and shelving.

Clean linen should be transported around wards on a clean trolley and handled with clean hands; trolleys should be covered when not in use.

All storage areas for linen including linen skips must be in a good state of repair to enable them to be easily cleaned There should be an adequate and timely supply of clean linen

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Unsatisfactory laundry provision should be reported to the site facilities manager or equivalent.

Soiled or Infected Linen This is any used linen which is soiled with blood or any other body fluid; and all linen used by a patient with a known infection (whether soiled or not). Staff should wear PPE and bag the linen in such a way as to minimise the risk of infection.

All soiled / infected linen must be placed in a red soluble alginate bag, inside a red laundry bag or bag clearly labelled as “Infectious”. The soluble bag must not be overloaded and must be placed directly into the washing machine to minimise contact and prevent transmission of infection to laundry staff or contamination of the environment.

Used Linen All linen which has been used by service users but not contaminated with body fluids All used linen must be handled with care, to minimise transmission of microorganisms via dust and skin scales. PPE must be worn when there is potential for contamination of clothing, i.e. when changing beds. Care must be taken to ensure there are no extraneous items are concealed within the dirty linen before it is placed into the laundry bag, such items may be potentially dangerous to staff handling the laundry and may also damage laundry equipment. All used linen must be placed carefully and directly into the appropriate laundry bag on removal from the bed or patient. Dirty linen must never be transported around the care environment unless it is within an appropriately colour coded washable linen bag. The use of a wheeled linen skip will protect the bags from damage and keep them off the floor. Linen bags to be laundered after each use.

Hands must be washed immediately following the handling of any used linen.

To avoid spillage of used linen, linen bags must never be more than two thirds full of an acceptable weight, and must be securely tied prior to transport to the laundry. Full linen bags must be stored in a secure area, away from public access, whilst awaiting collection.

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Bed linen Service users bedding should be washed weekly or more frequently if soiled.

All hospital bed linen and hospital towels must be laundered by a laundry contractor. The Infection Prevention and Control Team must be consulted on the negotiation of any contract / specification for laundry services.

Transportation of Linen

Vehicles or trolleys used for the transportation of used linen must be easy to clean, and must be cleaned after transportation of used linen. There must be no contact between clean and soiled linen at any time. Records of cleaning of vehicles used for the transportation of linen should be maintained.

On - site laundry facilities for washing service users clothing An on-site laundry must be situated within a designated room that is used for laundry purposes only. Access to this room should be limited to staff involved in the laundry process or to clients who are performing their own laundry.

The room should be well lit and well ventilated. The floors, walls, splash-backs and work surfaces must be impervious and easy to clean. Cleaning of the room should take place on a daily basis. All washing machines to be kept clean and free from algae. No eating, drinking or smoking is permitted in the laundry.

The design of the laundry should facilitate the creation of clean and dirty areas, i.e. dirty laundry can be brought into the laundry, processed and come out as clean linen, without it becoming contaminated by dirty linen.

Soiled or infected patient clothing (which should be placed into the machine in a red alginate bag) should be washed separately, using the hottest wash advised on the label for the fabric. The washing machine must not be overloaded.

Hands should be washed after any contact with dirty laundry, and appropriate PPE worn for any contact with blood or body fluids. All items should be dried as soon as possible using a externally vented tumble drier.

Laundry bins should be cleaned at least weekly. Washing machines should be disinfected weekly by running a hot programme without a load.

On site laundrettes for the washing of service users items must have the

following facilities and equipment:

• Washing machine/s (industrial type with a sluice cycle) on a plinth.

• Tumble drier/s- must be vented to an external wall.

• Hand wash basin with lever-operated mixer taps, liquid soap and hand drying facilities.

• A foot operated bin for paper towels

• Disposable gloves and aprons

• Waterproof plasters available nearby

• Segregated area for dirty linen

• Segregated area for clean linen storage

• Ironing and folding area

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Personal items All personal items of clothing which cannot be taken home by visitors / relatives, should be laundered on-site. If soiled items are to be taken home they should be placed into an alginate clothing bag (for leaflet providing guidance on washing clothes at home see Appendix 4), no pre-washing or soaking of the item must take place in the clinical area. Alginate bags are provided for use in domestic machines, they must be the type with a dissolvable seam, as fully soluble bags may cause blockage. Soiled items should not be left for more than 24hours. There should be local procedures ensuring relatives are aware soiled items will be laundered on site after 24 hours.

Personal items should be carried in a laundry basket or bag to the laundry room. Items must be placed in an alginate bag at the point of care if infected or foul and washed separately on the appropriate cycle.

In ward areas and assisted living accommodation an individual washable linen bag or basket should be in each bedroom.

Staff should ensure that washing takes place at least weekly and more frequently if personal items are soiled.

Uniforms Uniforms and clothing of clinical staff should be washed at home, separately from other items, and must be washed at the highest temperature allowed for the fabric (with a cold pre-wash if soiled). Tumble drying and ironing will further reduce microbial contamination. A clean uniform should be worn every day.

If a uniform becomes contaminated with blood or body fluid, it must be changed for a clean one as soon as possible. Staff should ensure they have access to a clean uniform in case of contamination. The contaminated item should be placed in an alginate bag.

Curtains / Soft Furnishings

Curtains in clinical areas must be laundered on an annual basis or after an outbreak of infection as advised by the Infection Prevention and Control Team and when soiled. Any curtains purchased for clinical areas must be machine washable or disposable. Spare sets of curtains must be available.

Within clinical areas, soft furnishings such as chairs must be purchased with fluid repellent upholstery. Any stained or soiled chairs should be steam cleaned, re-upholstered or discarded as soon as possible.

Pillows Pillows must not be laundered. Pillows must be covered with an impervious waterproof cover or single patient use. If the pillow becomes soiled, it must be discarded as soon as possible.

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Manual handling equipment Service users should have either their own hoist sling or a disposable sling until discharge from hospital, when this should be laundered or disposed of, as appropriate. Service users should have their own sliding sheet if required, which should be laundered on discharge from hospital. Where there is any soiling of fabric items, they must be laundered.

Mop heads Mop heads must either be disposable or machine washed on a daily basis.

Community Clinics Paper couch roll should be used as a covering for examination couches.

Examination couches and pillows must have intact impervious coverings, so that they are not contaminated in the event of a spillage of blood or body fluids.

Advice on dealing with soiled / infected linen in the patient’s home In the patient’s home, the washing machine may be in the kitchen. If soiled or infected linen needs to be washed, this should not be done at the same time as food is being prepared. Soiled or infected linen should be washed separately, after all other laundry, using the hottest wash possible for the fabric.

Overloading of the machine should be avoided.

Hands should be washed after any contact with dirty linen, and PPE worn for any contact with blood or body fluids.

Definitions Used Linen- This is linen that is soiled by use or fouled by bodily secretions.

Linen that is heavily fouled must be treated as infected linen.

Infected Linen- Is linen from service users known or suspected to have an infection. Linen that has no visible soiling or hasn’t been used by someone who is known or suspected of having infection Heat Label- Where a label states a lower recommended washing temperature.

Linen- Hospital sheets, towels, pillowcases, curtains Laundry- Service users/ Service Users personal clothing Please see Service Users and Carers Laundry Leaflet - Appendix 4

6.4 Waste Management Producers of waste have a duty of care to ensure that the waste is safely managed at all stages of handling and transportation until its final disposal.

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See Corporate Waste Management Policy.

6.4.1 Infection Prevention and Control Guidelines All staff working in areas where clinical waste (Hazardous and Non Hazardous Waste) arises must adopt safe working practices and adhere to the Infection Prevention and Control Guidelines. Failure to do so may result in prosecution.

The person in charge of every ward, department, area and home has a duty to ensure that all clinical waste is bagged/binned, labelled and stored appropriately for collection and disposal.

Where appropriate, any service user or carer who handles healthcare waste should be provided with sufficient education and training for them to safely handle, store and dispose of waste.

6.4.2 Categories of Waste.

Waste regulations now require the classification of waste on the basis of its hazardous characteristics.

6.4.3 Non Hazardous Waste.

Non Hazardous Clinical Waste may be disposed of in yellow and black (Tiger) waste receptacles (bins/bags) This waste can be disposed of to deep landfill The majority of clinical waste produced in Mersey Care NHS Trust is non hazardous, only small amounts of hazardous infectious waste are generated, This is waste that has not been contaminated with infected blood, bodily fluids

and or chemicals and includes:

• Dressings (not contaminated with infectious bodily fluids)

• Disposable gloves (not contaminated with infectious bodily fluids)

• Disposable aprons (not contaminated with infectious bodily fluids)

• Masks

• Incontinence pads

• Urine Bags

• Catheters

• Peg Feeds

• Paper Mache Urine Bottles, Bedpans, Bowls, Trays 6.4.4 Hazardous Infectious Waste.

This is the waste that has been contaminated with, faeces, vomit, blood,

exudates and other infectious bodily fluids:

• Paper towels if contaminated with infectious body fluids

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• Swabs used for cleaning infected wounds.

• Dressings from infected wounds.

• Used bodily fluid Spill Wipes (Spill kit)

• Anything else that is contaminated with INFECTIOUS bodily fluids, including Personal Protective Equipment (PPE) Only during outbreaks of infection should all bodily fluids be assumed to be infectious and disposed of in the infectious waste stream.

In all other circumstances clinical indications and or lab results should be used to inform decision to designate to infectious waste stream.

This waste requires disposal by alternative treatments and must go into Orange receptacles (bags/ bins).

6.4.5 Waste Containers Sharps Yellow Top (See also section 3.19 Key points to minimise risk) These are provided for the disposal of sharps contaminated by medicinal waste, or from venepuncture and are disposed for incineration.

The following should be disposed of into sharps containers: All needles including safety needles and syringes (activate mechanism first)

• Glass ampoules.

• Razors.

• Stitch cutters.

• Any other contaminated medical sharp.

If patient is self administering medication, sharps container must be given to the patient for them to dispose of used needle themselves at point of care.

Purple Top Container These must be used for the disposal of anything that may be contaminated with Cytotoxic or Cytostatic medication (even traces ). These have to be incinerated in permitted or licensed facility.

The labels on the containers must be completed when a new box is brought into use.

The Trust has a duty to ensure that all containers are stored securely, transported, incinerated and labelled correctly.

6.4.6 Mattresses: Bulk Collection of Waste Non-contaminated Mattresses Mattresses which have not been contaminated internally with bodily fluids

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should be cleaned with high level disinfectant and placed into a clear mattress bag. Clear bags can be requested from the Transport Department when arranging collection.

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