1. -DR.SHARAD H.GAJURYAL JR,MD(HOSPITAL ADMINISTRATION) B.P KOIRALA INSTITUE OF HEALTH SCIENCES, DHARAN,NEPAL

2. Introduction Linen and Laundry services are responsible for providing safe, clean, adequate and timely supply linen to user units of hospital at right time, right price and right place. 3. Linen is a general term used to denote clothing items. It includes all the textile used in hospitals including Mattress, bed cover, pillow cover, bed sheets, towel, blanket, screen, curtain, doctors coat ,table cover etc. Cotton is most preferred and frequently used material as it is cheaper and more comfortable. 4. Hospital laundry receives all the linen material from different areas like ward, OT, OPD, and office area where they undergo process of sorting, washing , extracting, drying, ironing, folding, mending and delivery. The OT linen materials need special care since it has to be washed & sterilized carefully. So if possible, the hospital can go for separate laundry process for OT linen materials alone 5. WHY IMPORTANCE TO LINEN?? Most of the patients readily accept the professional service of their doctors and nurses without or with minimum amount of criticism , They can judge the hospital by personal care and attention given to them while they are confined to hospital bed. Criticism of linen service by both patient and their visitor personals is one of the most frequently complaints heard in the hospital. The major share of this criticism can be avoided by properly planned linen and laundry services. 6. Adequate supply of clean linen sufficient for comfort and saftey of patient and personal appereance & pleasant, neatly attired employees attending patients in fresh crisp uniform do much sell the hospital to the public 7. Types of Linen Linen for Housekeeping-This includes curtains, drapes, table cloths , etc Patient linen- Bed Linen, Body Linen, OT Linen Staff linen-Doctors and Medical staffs Apron, Gown etc 8. Objective of laundry services To provide comfortable and pleasant environment to patient and visitors of hospital by supplying clean linen. To control Hospital Infection (3-4% of HAI is due to mishandling of the infected linen) To supply uninterrupted supply of linen to user department. To improve image of the hospital 9. Types of Laundry Services Rental System Contractual System In Plant System Co-operative System 10. Contractual system : In this system, Hospital owns the linen but has no mean of laundering it. It hires a contractor whose job is to collect linen and after laundering delivers to hospital. Some time the hospital also provide space and facility for laundering. Disadvantage for rental system is that it may leads to mixing of linen and chance of cross infection are more. 11. Rental system: Especially for the hospital with small size where it will not be economical to have their own laundry. In this system, the hospital hires laundered linen from contractor on rental basis. This system is advisable for small hospital upto 50 beds. 12. In plant system: In this system , the hospital have its own laundry plant.It is one of the best method for washing hospital linen. This type of laundry is more suitable for hospital of bigger size. Advantage are : Loss and damage of linen reduced, reduction in cross infection. 13. Cooperative system: In this system, a single laundry caters to number of hospitals. This system is most economic. It is suitable for hospital of small size and nursing homes . Disadvantage are chance of higher cross infection, also if there is strike in one laundry , it affects functioning of many hospitals. 14. Activities in laundry Collecting and receiving dirty and soiled linen from wards and other dept. Sorting of linen Removing of blood stains Disinfection Washing and Drying Repairing/ sewing Pressing/calendering and folding Storage Issue of material 15. WORKFLOW OF HOSPITAL LAUNDRY 16. Ancillary Facilities Laundry Managers Office Tailoring Area Workers Rest room Toilets Boiler room Stores 17. Physical facilities Location : Should be located in mechanical and electrical area with facility of electricity, proper ventilation,water, drainage system and steam. Also can be in close proximity of CSSD and Dietary system due to commom requirement steam in these areas. Ground floor with least disturbance to patients. 18. Space requirement : 10sq.feet/bed Physical layout : U shaped or rectangular shape Designing: Designing should be in such way that it should help the main processes which are Sorting, washing, hydro-extraction, drying, ironing, calendering, folding and packing It is always advisable to sepreate area into two parts i.e sorting washing and hydroextraction in one part and clean linen processing in other part. Processing of OT linen should be in separate space 19. Floors and ceiling : Floor should be rust proof , non- slippary, washable,suffient gradient to provide easy flow of water. Ceiling should be smooth ,washable, moisture proof , sound proof, with minimum height of 3.5 meter. Wall should be washable and free from crevices, corners,edge or projection.with light color as they contribute good reflection of light. 20. Doors and windows : Doors should be wide enough to admit heavy machinery and trolleys. Maximum light and natural ventilation should be provided from window. For ventilation,10 air change per hour is recommended. Lightening: Day light should be used if possible which helps to increase productivity and improve efficiency. 21. Power supply: 3 KW hour per 45 KG of laundry, The distribution panel should be easily accesible and should be away from direct path of escaping water vapor. There shuld be a stand by generator. Water: There should be provision of adequate supply of water. Aprrox 15 liter of hot water and 10 liter of cold water required per 0.5 kg of linen processed. IF 22. Steam Supply: A temperature of 170 degree Celsius is obtained from steam at 45 kg per 6 sq. cm pressure. All steam line should be properly insulated for protection of workers. Fire safety: provision of extinguisher should be located throughout the laundry with fire detection system and alarm. Workers should be instructed not to smoke in laundry while working. They should be trained how to use fire extinguisher. No electric equipment should be left on after working. 23. Sewing room: should be located near to processing of clean linen and packing room. Laundry managers room : should be located centrally so that manager may properly supervise the entire laundry operation. wall should include a large vision panel to allow full view of the areas. 24. List of files and registers 1. Linen stock register 2. Daily transaction register for wards 3. Daily transaction register for other areas 4. Dhobi pay register 5. Camp register 25. Staffing pattern Four category of workers are required in laundry; Supervisor Operational Semi-skilled Unskilled Training in infection control and basic hygiene should be given to all workers. There are various formula for calculating staffs in laundry: 26. A-one washer man for each 60-75 kg of linen One man for each 30 bed in hospital As per recommendation of US department of health Approx. personal excluding mangers are : -75 bed 7 personal 100-175 bed 12 personal 200-300 bed 15 personal 27. For 500 bed -laundry manager-1 Supervisor-1 Store keeper-2 Orderlies-6 Tailor-1 Sweeper -1 Operators-17 28. Requirement of linen Amount of linen required in different wards, OT , opd differs from hospital to hospital. As a rough guide,2- 3.5kg of linen per patient per day is required. If we presume bed occupancy of 100% maximum 4-6 set of linen are required as : One in use One ready for use One being processed One in transit Two set for weekends and holidays/exigency in stock 29. Equipments The number and type of equipment required depends upon various factor Type of hospital Size of hospital Linen load Type of laundry system in existance 30. Major equipments needed are : Boilers Washing Machine Hydro extraction machine Drying Tumblers Calendaring machine Steam bed press Electric hand press Sweing maching Weighing scale Fire extinguisher Trolleys 31. Washing machine 32. Hydro extracting machine 33. Equipments of linen and laundry WASHER CUM EXTRACTOR- This is a combination of washer and an extractor in one unit. Hydroextractor- also simply called extractor , removal of water after the washing cycle in the washer. 34. EQUIPMENTS OF LINEN AND LAUNDRY DRYER OR TRUMBLER- A HYDROEXTRACTOR EXTRACTS ALMOST 80% OF WATER FROM THE LINEN. A dryer brings the linen up to an almost dry state. FLAT BED PRESS- 35. Policy and procedures Type of laundry Type of linen Control of pilferage and theft System of distribution of linen to user units Planned preventive maintenance program for laundry equipments Training of operator and other staffs for universal precaution and operations of machines Inventory control Condemnation and disposal Maintenance of history sheet of equipments 36. THE END