After clean health care textiles have been delivered to your hospital’s loading dock, what happens next? As in most hospitals, they are delivered to a designated area. Unfortunately, that simple process may open up many opportunities for contamination. That is why it is so important to have a policy and procedure in place. If your hospital has one, chances are that it covers the handling of contaminated textiles, but may not address the handling of clean textiles.

The Centers for Medicare & Medicaid Services, the Occupational Safety & Health Administration, the Healthcare Laundry Accreditation Council (HLAC) and the Association for Professionals in Infection Control and Epidemiology are a few of the organizations that regulate how contaminated textiles should be handled — but they lack specific protocols about how to handle clean items.

Take, for example, a few of the typical health care textile mishaps. Linen carts that are typically stationed in patient care areas are allowed to gather dust and dirt and are rarely cleaned. Many times textiles that have fallen on the floor are picked up and placed back onto the cart; however, this should never happen because they are now contaminated. According to research, outbreaks of infectious diseases associated with laundered health care textiles over the past 43 years have affected at least 350 patients worldwide. The cause of those infections have been exposure of clean textiles to environmental contamination.

Pathogens can exist from hours to months on environmental surfaces, and health care textiles are an environmental surface. One supporting study can be found in Clinical Infectious Diseases, Volume 39, Issue 8. There also are studies that implicate health care workers’ uniforms in spreading pathogens. That’s one reason for prohibiting hospital staff from carrying clean textiles against their uniforms and leaning on patient beds while delivering care and treatment.

Hospital personnel must embrace the importance of hygienically clean textiles, including infection prevention textiles used by environmental services. There has been a necessary push to instruct health care workers on the importance of hand hygiene, but the push has failed to connect hand-hygiene compliance with handling clean textiles and the potential for their contamination.

In the March 2014 issue of Health Facilities Management, my column, “Handling textiles in the hospital environment,” lists steps to include in a policy and procedure document. Also, on the HLAC website (, you can download and personalize a complete policy and procedure sample for your facility.

John Scherberger, CHESP, REH is the owner of Healthcare Risk Mitigation. He is the AHE representative to the HLAC, on which he serves as board vice president.

Valuable resources available from AHE

AHE represents, defines and advances the professionals responsible for care of the health care environment to ensure high-quality outcomes and healthy communities. The following resources can be found at

Recommended Practice Series: Environmental Services Equipment and Supplies. The equipment and supplies covered in this booklet are essential, discrete components of safe, efficient and productive environmental services operations.

• Practice Guidance for Healthcare Environmental Cleaning, second edition. This manual provides evidence-based research, guidance and recommended practices that should be considered for inclusion in health care environmental services departments. Because each health care facility has its own needs, this resource has been designed to enhance an existing program.

Environmental Sustainability Certificate Program

AHE has launched a new certificate program to acknowledge the ongoing and outstanding environmental and ecological sustainability efforts of environmental services departments. For more on the Environmental Sustainability Certificate Program, go to