Hospital linen management is a highly regulated process designed to prevent the spread of infection and maintain a safe environment for both patients and staff. Soiled textiles are a potential pathway for microbial transmission, requiring strict adherence to protocols established by the Occupational Safety and Health Administration (OSHA). Proper handling, from the point of use to final cleaning or disposal, is a fundamental component of a facility’s infection control program. This systematic approach ensures contaminated items are contained and processed without risking cross-contamination or occupational exposure to bloodborne pathogens.
Categorizing Contamination Levels
The proper handling procedure for hospital linen begins with accurately categorizing its contamination level at the point of origin. Healthcare textiles generally fall into three distinct categories, each dictating a specific containment method. The first category is clean or unused linen, which is held to strict storage and transport standards to maintain its hygienic state.
The second category is general soiled linen, including items like used bed sheets, towels, and clothing not visibly contaminated with blood or other potentially infectious materials (OPIM). This material requires careful handling to prevent microbial dispersal but is typically placed in a standard collection bag, often white or blue, for routine laundering. The third and most regulated category is infectious or contaminated linen, defined by OSHA as laundry soiled with blood or OPIM, or materials used by a patient in isolation. This linen must be contained in a specialized, leak-proof bag, frequently red or marked with a biohazard symbol, to alert handlers to the potential risk. According to OSHA guidance, contaminated linen intended for reuse is not considered regulated medical waste.
Standard Collection and Containment Procedures
The immediate actions taken at the bedside are the most important for minimizing the risk of infection and injury during handling. Staff must always wear appropriate personal protective equipment (PPE), such as gloves and gowns, before touching any soiled textiles. When removing linen, healthcare workers should handle it as little as possible and with minimal agitation to prevent the generation of infectious lint aerosols.
A key procedural step is to carefully roll the soiled linen inward from the edges, creating a bundle that contains the contaminated inner surface. Linen should never be shaken, as this increases the likelihood of spreading microorganisms into the air and onto surfaces. All contaminated textiles must be placed directly into a designated bag or container at the point of use; sorting or rinsing in patient care areas is prohibited. For infectious linen, a common technique is using a water-soluble plastic bag (often red) placed inside a secondary bag, ensuring the outer layer remains clean and dry for transport.
Safe Transport and Storage Protocols
Once contained, the soiled linen must be moved using protocols designed to prevent cross-contamination within the facility. The bags are immediately sealed and placed into designated, covered laundry hampers or carts, which are often color-coded or clearly labeled. These transport containers must be in good repair and routinely cleaned and disinfected after each use.
Transport routes for soiled linen are planned to avoid high-traffic patient and public areas, maintaining physical separation from the clean linen flow. Temporary storage areas must be secured, separate from clean linen storage, and designated solely for holding used textiles. If a bag breaks or a spill occurs during transport, the area must be immediately isolated, and a specific cleanup procedure initiated using appropriate PPE and disinfectants.
Processing and Final Disposition
The final stage of proper linen management occurs when the textiles reach the facility’s laundry or an external processing service. The goal of laundering is to render the items hygienically clean, achieved through a combination of mechanical, chemical, and thermal action. High-temperature washing cycles are the standard for thermal disinfection, often requiring the load to be maintained at a temperature of at least 160°F (71°C) for 3 minutes, or 150°F (65°C) for 10 minutes, to effectively kill common pathogens.
The process also incorporates chemical factors, such as detergents that suspend soil and chlorine bleach, which provides an added margin of safety against microorganisms. Specialized barrier washer-extractors are common; these machines are loaded from the contaminated side and unloaded from the clean side, physically separating the dirty and clean zones. Any linen damaged beyond repair, such as items with irreparable tears or those heavily soiled with material that cannot be safely laundered, must be transitioned to the regulated medical waste stream. These non-reusable items are disposed of via incineration or other specialized methods, completing the closed-loop cycle of hospital textile management.