Properly handling linens soiled with incontinent feces is a fundamental procedure in healthcare, directly impacting infection prevention and patient safety. Standard precautions require that all body fluids, secretions, and excretions, including stool, be treated as potentially infectious material. Feces can harbor a variety of pathogenic microorganisms, such as Clostridioides difficile spores or Norovirus, which can easily be transferred to surfaces, equipment, and personnel. Controlling this source of contamination is a primary step in preventing healthcare-associated infections and maintaining a clean care environment. Adherence to protocol protects the patient, the nurse, and other individuals within the facility.
Essential Safety Preparations
Before initiating the cleanup, the nurse must perform a point-of-care risk assessment to determine the appropriate Personal Protective Equipment (PPE) needed. Hand hygiene is mandatory before donning any protective gear to ensure a clean barrier is established.
At a minimum, a disposable, fluid-resistant gown and non-sterile gloves are required for handling the contaminated linens. The gown prevents the soiling of the nurse’s uniform, which could transfer pathogens to other areas of the hospital. If there is any anticipated risk of splashing, eye protection, such as a face shield or goggles, must also be worn. Necessary supplies, including a designated leak-proof linen bag or hamper, should be gathered and positioned immediately adjacent to the patient’s bed for swift containment.
The Physical Removal and Containment Process
The removal of the soiled linen must limit the dispersal of microorganisms into the air and onto surrounding surfaces. If a large, solid amount of fecal matter is present, the nurse should first attempt to remove the material using a flat object, like a bedpan scraper or a wad of toilet tissue, and dispose of it directly into the commode. This action prevents the heavy soiling from potentially damaging laundry equipment during processing. The linen itself must be handled as little as possible, which reduces the contact time and likelihood of cross-contamination.
When removing the linen from the bed, the nurse should carefully roll or fold it inward so the most contaminated surface is contained within the center of the bundle, minimizing contact with the nurse’s gown and the environment. Avoid shaking or tossing the soiled linen at any point during removal. Shaking can create aerosols, which are microscopic airborne particles that can carry pathogens and settle on nearby surfaces or equipment. The rolled linen must then be placed immediately into the designated leak-proof bag or hamper, which should be brought directly to the bedside.
Linens should never be sorted, counted, or rinsed in the patient care area, as this increases the risk of environmental contamination and pathogen exposure. Once the soiled linen is securely placed in the container, the nurse must ensure the leak-proof bag is sealed or the hamper is closed before leaving the patient’s immediate vicinity. Holding the bag away from the body during transport reduces the chance of contaminating the nurse’s uniform or skin. Avoid overfilling the bags to maintain containment integrity and prevent tearing or spillage.
Finalizing Hygiene and Environmental Safety
Once the soiled linens are contained, the nurse must focus on the removal and disposal of the contaminated PPE. The doffing process is a sequence designed to prevent pathogen transfer from the soiled outer surface of the gear to the skin or clothing. The gloves are removed first, followed by the gown, and finally, the eye protection, if used. Each item of PPE must be treated as contaminated waste and placed directly into the designated receptacle.
Immediately following PPE disposal, the nurse must perform meticulous hand hygiene, using soap and water or an alcohol-based hand sanitizer. Handwashing is particularly important when dealing with feces, especially if C. difficile is suspected, as alcohol sanitizers are less effective against its spores.
Any surfaces or non-disposable equipment contaminated during the process (such as the bed rail, bedside table, or linen hamper exterior) must be cleaned and disinfected using a hospital-approved germicidal agent. The contained linens should then be transported without delay to the soiled utility room for transfer to the facility’s laundry service, ensuring the sealed bag is not carried against the body.