UNIT 3 L RY SERVICES

3;O Objectives
3.1 Introduction
3.2 Definition
3.3 Importance, Roles and Functions
3.4 Types of Laundry $emices
3.5 Categories of Linen in Hospital
3.6 Planning Consideration
3.6.1 Lineq Requirements
3.6.2 Mechanised Laundry Service
3.6.3 Physical Facilities
3.6.4 Equipment Requirements and Maintenance
3.6.5 Organisation and Staff~ng
3.7 Laundry Processes
3.7.1 Main Laundry Process
3.7.2 Operational Aspects of Washing
3.7.3 Washing Fornula
3.8 Linen Distribution System
-
3.8.1 Centralised Linen Distribution System
3.8.2 Linen Inventories
3.8.3 Maintenance of Linen
3.9 Administrative Policies arid Procedures
3.10 Linen Control
3.11 Quality Assurance
'..
3.12 Let US Suin up
3.13 Answers to Check Your Progress
3.14 Further Readings

After going through this unit, you should be able to:

define the term hospital linen;
e describe the importance, roles and functions of linen and Laundry services;
list the types of laundry services and categories of linen;
describe parameters of planning, organisation and staffing af linen and laundry services;
enumerate the steps of main process of laundry and procedures of washing; .
e explain briefly the systems of distribution of linen;
list the various admittistrative policies and procedures; and
describe linen control and quality assurance programmes;

3,1 INTRODUCTION
Out of all the supportive Services in a hospital, linen and laundry are one of the
important services. The main objective of this service is to provide adequate quantity
Support and U ~ l t ~crvlcek-~
y of the right quality linen to the indoor patients-the operalion theatres-OPD end
other weas and to the medical and para-medical personnel engaged in medical care
services provision in hospital. hi this unit, you will learn about thc planning,
orga~iisatio~iand management of this important service. To begin with you will learn
about the what co~istitutegood lau~idryservice ih a hospital, its importance, and
various types of organisation of laundry services. Further you will learn about various
plmiiing considerations including physical equipment.
You will also learn about main laundry processes including linen control programme
and distribution of linen. Towards the end, you will learn aboul various administrative
problems and procedures including quality management.

3.2 DEFINITION
The word laundry is derived from launder$r/laundress--which means washerman or
washerwoman. By hospital linen we mean all clothings made of cottan, linen or wool
or synthetic fabrics, which are used by tlie patient or for him. Linens or textiles are
composed of certain basic fabrics which are spun into yarll. Yarn intun1 is woven illto
cloth by one or more of the basic weaves.
It is recommended that, fabrics used in hospital have certain specific qualities so that it
may not affect adversely on the heallh of patients, medical and para-medical
personnel. The Ihen must havgpproper rnoisture repelliency, dry cfticiency, surface
fluff, stre~igthetc. It should be staiic safety yid lnust not be.& high llam~nahility.
For the hospital linen service, from tKe administrative point of view, due consideration
should be given to the three basic factors i.e. service, quality and.ecotio~ny.
e Service involves frequency of changing patient linen, linen control, distributio~i
procedures and duration of time at the laundry.
e Quality involves the sanitation of linen, its visual appearance and the microbial
status.
e Economy involves the consideration of what it actu4dllycosts the liospital lo
provide linen service per patient per day.

3.3 IMPORTANCE, ROLES AND FUNCTIONS

The importance of providing clean linen to the patient can be discussctl u~iderthe
fallowing headings:
i) Cross Infection ,

Providing of clean linen to the patient, frequent change of linen and its effective .
washing serve as a well known preventive and liygienic measure in co~ltrollingcross
infection in hospital.
ii) Patient's Comfort and Satisfaction

. A patient not only expects hut demands clean bed antbody linen during his stay in ,
the hospital. Supply of adequate clean linen helps in c~~suring
patients satisfaction.
Fabrics, properly chosen, can give comfort, wannth or coolneSs to the patient.
iii) Aesthetic Aspect
Clean linen in a ward makes it look more cheerful and'at$sthetically bettutiful and
pleasadt. It pleases the patient and thCStaff working in:W ward. For decorative
value specific fabrics may be cboosen.
iv) Human/Public Relation
Clean ward displaying bright, crisp and clean linen makes pleasarit impact on all who
work or visit in the hospital. The good impressioninstills confidence in llle patients
42

-
and the public, and enhances their faith in the medical services rendered by the Linen and Laundry Servlccs
hospital. Simultaneously, it bespeaks of competence and efficiency of the medical
care service.

3.4 TYPES OF LAUNDRY SERVICES

i) In-plant System

Here a hospital fulls its own laundry. The system can only be justified for very large
hospitals and teaching institution as it is very exnensive.

In this system, the hospital has its own linen and laundry and all the activities of the
hospital laundry service like washing, ~nendi~ig arid replacement are done in the
hospital premises.

ii) Rental System

In the system liospitals hire laundered linens from rhe contractor. The contractor is
also responsible for the replacement as well as laundering of patients and staff linen.
The main advantage of Rental Lineti Supply System is that the hospital does not have
t o spend ln~jchfor this vital service.

iii) Contract System

Here, hospitals ow11their linen but have no means of laundering. Washing,

conditioning and prcssiiig are carried out on contract Hasis from outside. In some
cases, howevcr, ii subsidized contract type is pr-evaleatand in such case the hospitals
provide water !uid washing area within the hospital premises.

iv) Co-operative System

A single laundry is run on co-operative system to cater for a number of hospitals.

This system is very economical. It can ideally be adopted for government hospitalsla
group of smaller liospitals.

The ce~ittalisedlaundry tends to be more beneficial for tlie srnallcr hospitals than the
larger hospitals as inany small hospitals share the services of highly qualified laundry
managers and most modern ~nachineriesand automation. Tlie centralised laundry
organisation can lnaintain standardization of li~ienfor all tlie hospitals and evolve
common policies of purchase, supplies and maintenance of linen.

3.5 CATEGORIES OF LINEN IN HOSPITAL

Hospital linen can be classified in the following categories:
1 Store Linen
i) Patient linen:
a) Body linen
b) Bed linen
ii) Stat'l' linen: Linen used by the hospitiil stal't'such as apron.
iii) Departmentlservicc linen: Linen used by the departments.
2) ~ a u d r Linen
y
to the processes it has to undergo for washing.
Here, the linen is classifled accordi~~g
i) Soiled Linen
The linen that has beeti used by the patient is tenncd as soiled linen. It ontlcrpncs the
usual process of collection, washing, coaditioniup and pressing. 'I?) i1voi.i lill~,1~:!:1i
Support and Utility Sefflas-1 infection, it has been suggested that sorting of soiled linen should not be done in a
- ward or operation theatre area. They must immediately be placed in washable bags
properly marked or labelled, and must be sent to laundry.
ii) Infected Linen
The linen contaminates by infected material such as pub blood, body discharges etc.
is tenned as infected linen. Contaminatedlil~fectedlinen is collected in polythene bags
secured by red ribbon and it is least handled. It goes through the process of sluicing
and soakage in disinfectant solution prior to passing through the normal process of
washing, conditioning and pressing. Baby napkin is always considered as
contaminated linen.
iii) ' FoulLinen

This type.of linen contains faeces, excretions and blood stain. In the past, fdr this
type of linen, hand sluicing was done, by Nursing Orderlies or sweepers.
After sluicing, this type of linen was sent to laundry for washing. Now-a-days, this
type of linen is collected from the patient care area in water proof containers 3nd sen
to central sluicil~gplant from where, after sluicing, the linen is sent to laundry for
washing.
iv) ~hdio-activeLinen
Linen contaminated by a radio activo inaterial is segregated and ~nonitoredwith
suitable detector. The articles are PUSinto a special washer rcscrved solely for this
purpose and when found to be free from detectiible radiation'these aresent to the
hospital laundry and processed with other linen.
Check Your Progress 1

1) Define the term "IIospital Linen".

2) List the types of organisation of Lauildry Services.

............. ..................................................................................
I..........,..............).........
1

................................................................................................................................... 1;
I

. 3.6 PLANNING CONSIDERATION ,

I

3.6.1 Linen Requirements

Linen requirements are calculated based on operational planning of areas of differenl
activities.
e Fixed areas (ODDSand other departmellts)
I

a Operation Theatre and labour room I

!
e Indoor and private ward etc.
(
1

The requirements for tlxed areas, OTs and labour rooms are based on the actual , i
performance, whereas, requirements for indoor and private wards are esti~natedat'the I
rate of 2 to 3.5 kg of dry linen per patient per day, For planning purposes, it is just
sufficient for alternate day change of linen. i
1
Ideally a hospital liaviiig 100% bed oc'cupaucy sliould have six sets linen per patient
as given below:

1) One set in patients' bed

2) One set,en-rou te to laundry

3) One set in process in laundry

4) One set ready.for use ,

5) Two sets for active storage for work and use in case of emergencies.

2.5 kglbedlday can be taken as average which is with alternate day change sets of
linen will be sufficient.

Replenishment Systeni

Once the iiumbcrs of beds and tlie specific quota of line11 are fixed, replenishment of
linen is made on the basis of the total number of different linen items sent for .
condemnation.

It is always better to put tlie year and Inode of issue. Whatever linen condeinned
should be deducted from the perpetual inventory aild additio~ialinput should be inade.
This system will provide the figure of total input of linen in tlie course of the year. IS
the number of condemtiatiori is very high, it needs immediate investigation.

3.6.2 Mechanised Laundry Service

Mechanised laundry service has already been established as tlie best mctliod for
washing of linen. It is not only convenient but safe, dependable aiid cheaper in
comparison to other methods. Due to lack of knowledge, the introduct.ioii of
mechanised laundry in Indiaii hospitals is rather poor.

Report of tlie study group on hospitals (Jain Cominit(ee) in the year 1968, lias
recommeiided very clearly tlint "Mechanised laundry should be adopted as rnkthod of
w,ashing linen in teaching hospitals." Sinall hospitals should group together and
obtain benefits of mechanised laundry. Even very smaller hospitals should einploy
domestic washing machine. Rao Corninittee has again emphasised the need of
inachanised laundry system.

3.6.3 Physical Facilities

Space and accommodation requirement:

1) Location of Laundry

The location should be convenieiit to the user units and on tl;e ground floor. If
possible, the laundry sliould be in the close proximity to CSSD and dietary services
due to common requirement of steain from boiler plant.

2 ) , Floor ArenlSpace Requirement

It is always better to have space more than what is actuillly required in view of future
expansion. .According to Dr. J.R. McGiboily, tlie area for laundry for a teaching
hospital in India sliould be at least 5800 sq. ft. According to asurvey of Delhi
hospitals the space requirements is, 10 sq, ft. per bed or 10 sq. ft, for 2.5 kg of linen
per day. In term of number of beds to the space requirement is cited below:
h

No. of Dcds Space

I
200-350 bed 3750 sq. ft.
350-500 bed 4000 sq. ft.
500-650 bed 4500 sq. ft.

( ?-650 bed 5000 sq. ft.

 ' Support and Utility Services-1 3) Physical Layout
'U' type, 'Rectangular' type or any other form may be adopted as considered suitable
keeping in view scientific workflow and availability of spacc.
4) Design of functional areas.
Reception Bay -+ Sorting Area -+ Sluice Room -+ Main Washing Area: washing,
hydro extracting, Drying -+ Ironing Area -+ Clean Storage Area --+ Issue Bay
Ancillaries
e Laundry Manager's Office;
e Stores;
I . e Tailoring Bay;
I
e Worker's Rest Room;

I e Toilet;

I e Boiler Room

I j) Material and Decor

I i) Flooring sllould be smooth, non-slippery, water-impervious.

ii) Walls should have a smooth, washable surface and should bc free frorn all
unnecessary corners, edges or projections, which could become a cleaning and
mainteuance problem. Walls should be painted in soothing pastel colours rather
than white to reduce glare.
iii) Ceiling should be smooth and washable surface and should be high enough to
allow installation and repair of all equipmeuts. The mail] laundry building should
have a clear headroom of 14 ft., and the roof sllould be built free from dust
collecting surfaces.

I iv) Doors should be wide enough to adrnit heavy milchincry and trolleys.
6) Ventilation
Recommended air changes are lothour. Exhaust Sans should he provided on :I liberal
scale, so as lo provide a comfortable environment tlirouglioul (lie year to enhance
personal comfort and efficiency of the workers.

I 7) Lighting

II
Day light should be used whenever possible. Good lighting is an i~np:.~:.t:~t.factor for
increasing productivity and quality of work. It should be free from gl;,1.2 .md
shadows.
.
, 8) Powersupply

I
Usually it is 220 or 440 watts, 3 phase, alternating current, connected to alternative
standby generator. The distribution panel must be readily accessible, preferably
located near the load centre away from the direct path of escaping steam or vapour.
The power requirement are as under:
i) For motorised equipment : 25 kwlh125 kg, of linen loaded in a drying tumblers
ii) For lighting: 3 Watts per Itsq. ft. of floor space.
9) Steam
Requirement is 170°C with 100 Psi. Ideal is 178" a1 100 Psi. I-Iowever,
specification given by the manufactures of washers and caldering machine must be
adhered to.
10) Water
Provision of adequate water supply througl~outthe day is of great importance. 'For
washing every kg of linen, 30 lit.res of hut water at a temperature of 70°C to 80°C and
10 litres olcold water are required. The hot water supply s11ould be piped to the'
laundry directly from the boiler room. For general planning 100 litres of water per bed Liireil and Laundry Services
per day is required for laundry purposes. f

If hardness of water exceed 3-4 grains, then water softening plant should also be used,
otherwise, scaling of elements will be a constant problem. Linen also acquires yellow
hue if washed with hard water.
I I) Fire Safety Measures ,

Provision of fire extinguishers is a must throughout the laundry. workers should be

aware of thc use of tire extinguishers and must be trained for fire fighting. They
should be instructed not to smoke inside the laundry. No electrical equipment should
be left on after the working hours.
12) Toilet, Locker and Shower Facilities
Enough facilities should be provided so that worker should change their clothes
before they start to work ant! hefore going home afler work. Facilities to wash and
cleai~theinselves s!~ouldbe provided. Soap, Oil etc. should be inadc available.
13) Sewing Rooni
The sewii~groom should be located near llle clean li~lenand pack preparation room so
that wrappers, surgical or obstetrical drapers etc. I'ound torn and reparable could'be
sorted out, stitclied and stored lhere, so enough space sbould be provided for the
sewing function.
14) Laundry Man:)ger9s,Office
This office should be located ;ISce~ltrallyas possible so that llle inantiger inay
properly supervise the entire laundry operalion. The walls should include large vision
panel to allow for i'ull view 01' each area.

3.6.4 Equipment Requirements and Maintenance

Equipment planning must be donc based on single eighl hour shift per day. As 2111d
when expansio~~ of hospital takes place a second eight hour shift can be started
doubling the capacity of laundry without adding any equipment. The following type
of equipments ace generally required for the mechanised laundry:
The number of ecluipmenls required inay be estimated considering the linen load i.e.
total weight of linen (in kg, or lb.) to be washed. For practical purposes.ihe following
factors-the ilumber of beds; the proportion of superspeciality and surgical beds; cost
incurred; space available; nuxnbcr ol'laurldry shifts per day; and capacity of the
equipment etc. sl~ouldbe taken into account.
1) Trolleys (Dry linen trolleys-diff capacity 50 arnd 100 kg., Wash room trolleys-
diff capacity 50 and 100 kg)
2) Sluice Machine-(15 kg capacity)

3) Boiler(s) (Boilers which generate s t e m or Iiot water are required for laundry)
4) Washing Machine(&-50-1 00 kg.
5) Hydro Extractors-50 kg.
6 ) Drier@)'(Drying Tumblers)-25-50 kg.

7) calendering Machine-(single roller) 80" x 60"

8) Stcam Bed Press-(47" x 14" x 9")
9) Electric Irons (Hand Press)
10) Sewing Maclli~le
11) Ironing Table (For usiiig hand presses)
12) Weighing Scales
 Support and UUllty Services-I* 13) Fire Extii~guishers
14) Air cornpressure for calendering machine
The laundry machines are available in different capacities in India frotn 5 kg to 100
kg. The number of machines and its capacity is calculated on the basis of total
quantity of dirty linen to be washed divided by working hours SO that linen need to be
washed per hour is known and accordingly machines can be purchased, On the hasis
of 2% kg linen per bed to be washed the requirement of machines can be calculated.

id >
~ a i n t e n i n c of
e Equipment
Installation and commissioning should be under close supervision and every stage of
it should be inspected and checked properly. Warranty period and aftcr sales service
should be well defined. Record of initial cost, operating cost should be recorded and
maintained. Availability of spare parts shouldbe ascertained. Various utilisat'on rates
and ratios should be found out periodically. 'Log book' and 'History sheet' of the
equipment should be maintained. Breakdown periods and down time for all
equiqmepp sb'ould be maintained. First level maintenance sl~ouldbe carried out
diligently by the user. System of regular and timely repairs either by in-house staff or
on 'service contract' should be adopted.
Check Your Progr'ess 2
. . . .
1) Enumerate
. .>
'the sets of Linen required per patient.

2) Fill in the blanks:

a) is ................
kcoording to survey of Delhi HospitaIs the space requireinc~~ts
of linen per day.
.. !: b) In terms of bed the space requirement for 200 to 350 beds is .........................
.
.
and for 500 to 650 beds is ...................... ........
3.6.5 Organisation and Staffing
Number of Personnel Required
The operator must be trained. He must know how to operate it otherwise even a good
machine will yo out of order in no time. It is always better to ask the supplier to train
the operators, before the hospitals take charge. It has been fouud that one dhobi/
laundry operator can handle at least 55-60 kgs of linen or one dhobi for 30 beds.
Apart from laundry operational stafl; a manalger should be made overall incharge. I-Ie
must be Diploma holder in machanical engineering with experience to run laundry for
5 years. If laundry is going to function more than one shift, then, every shift inust
have a supervisor as Incharge of the shift.
i) Parameters of Staffing
'
(e.g. for 500 beded teaching hospital)

1) Linen Load @ 2.5 kglBed1Day

= 2.5 x 300 = 1250 kglDay
2) Staff (Laundry Operator) @ 1 Per 60 kg/Day = 1250/60 = 20 (Excluding
Manager) I

- Manager A # 1
- Laundry Supervisor *I
- Laundry store keeper 2
i
 - Laundry orderlies Lincn and Luundry

- TailorjMender
- Safai Karmichari
- Washermen/Laundry operator
Receipt +- Sorting
Sluice
Washing Machines
Extractors
J

Driers
Calendering 4
Steam Press 1

~ o l d i n g+ Storage. 2
Despatch/collection 2 (By Laundry orderlies)
Other supporting staff
a Boiler Attendant
*
Electrician
a Mechanic 1
Note: The supporting staff can be dedicated to the laundry or made available
from the pool of engineering services of the hospital.
ii) Organisational Structure
Deputy Medical Superintendent
I
Officer Ilc Laundry

Laundry Manager

Laundry Supervisor

U.D.C./L .D3.C. Laundry Laundry Laundry

Store keeper Orderly Operator Safai Karanchari
Manpower Deployment
Suitable pattern may be adopted for deployment of personnel for the desired shifts i.e.
Morning, Evening and Night.

3.7 LAUNDRY PROCESSES

3.7.1 Mgin Laundry Process
Generally, delivery and collection of linen is made by laundry staff. After receiving
the linen in laundry if not infected, soiled or fouled, it is weighed. If it is infected or
fouled then it is processed through sluicing machine. In sluicing linen is washed with
cold water to remove dirtu, vomitus, faecal matters, blood and body fluids deposited
on clothes. Dirty Iioen after weighing undergoes following processes:
Support and ITfility Services-I e Washing: For optimum relnoval of dirts from clothes combined action of
detergents and ~nechanicalmovements of clothes through water is rdquired and
applied in mechanical washers.

Hydroextraction: By process of centrifugation, hydroextracto~machine extracts

or expells water from damp washed clothes.

e Drying: Drying tuinbler agitates the hydroextracted mass of washed linen inside
a cylinder so that steam passes througll tlie clothes at high temperatures. This
resulk in drying of linell.

e Calenderi~lgIWotIroning, Pressing or Hand Ironing: Flat bed steam press

corisists of concave, convex presses with tiny holes for passage of ste'm. Fabrics
get pressed by mechanical pressure 2u1d stearn.

e Mending
Folding, packing

3.7.2 Operadona! Aspects of Washing

It consist of' the following procedures:

a) Breaking
This is the first operation of adding soap chips and detergents like wasl~ingsoda or
commercial detergents to high temperature water in the washing mi~chineand
allowirig tlie mixture to break and build up suds.

Soiled linen are tllrown in the baskel containing tile soap suds and machine is operated
to agitiltc there by causing the suspension of dirt. Multiple sudsing of shorl duration
a1tern:llcd by 3 ~ninutcrinses is lnorc effective than continuous sudsing or rinsing.

c) Bleaching
Comlnercial bleaching algenls like Tinopal, Cl~lorinebleach or hydrogen pcroxide rnay
be used. Bleaching suds should not exceed 10 minutes duration and the temperalure
should not be more than 160°FE t

d) Rinsing

Rinsing is Hushing water through the linen in the machine to remove suspended dirt,
deterget~tsor bleaching agents.

This is better done after the final washing operation. Light, medium and heavy
starching should be consistently and uniformly done to the linen.
f) Solwing
I

This is done to neutralise the alkalinity in the wash lo give a good finishing
appearance to the linen. By adding a mild acid like boric acid or any kluoride acid in
the washing operation, the washed linen is freed of the yellowish colour.

g) Blueing

This should be the last operation. Any commercial blue will serve the purpose. .
h) Ironing

Calenderil~gmachines, flat work iro~lersand tiand-presses may be used for this

purpose. Normally 70% of washed linen will be for flat iron work, 25% rough dry
and 5% press work.
 3.7.3 Washing Formula
Washing Formulae

I1 .
Cotton white Cotton coloured Woollen 100 Ihs.
100 lbs dry 100 lbs dry 100 IBs dry
weight weiglit weigl~t

Washing Soap Chips 1.5 1

2. Washing soda 1 0.5

3. Bleaching powder 0.5 -
4. Whitener 0.05 -
- 1

140° F-160° F 150° F

Note: It shoi~ldbe adjusted to the degrce of hardness and softlless of the water.
Life of Linen
The life of linen is determined by the followiilg factors:
a) overall availability of sets of linen.
b) Type of laundry system under operation in the hospital. An in-plan1 system will
ensure a longer life span.
c) Type of the detergent being used for washing purposes and elTectiveness of (hc
Linen Control Committee. As per general experience 15-20% of the linen being
used in the hospital becomes unusable after a period of 3 months or after 35
washes.

3.8 LINEN DISTRIBUTION SYSTEM

In most of the hospitals, three corninon types of linen dislribulioi~syslelns lire
practised:
3.8.1 Centralised Linen Distribution System
In this system, the issue of liilen a~idlinen circulation is controlled by a central linen
room; which is also responsible for linen replacement, repair and condemnation.

I 1) Centrnlised Linen Services

There are four patterns of issue of linen from the central linen room:
i) "Clean for Dirty" Exchange System
In this systcm, tl~eissue of clean linen is done in place of dirty linen,
ii) Topping Up Systelrt ,

Under this system, the daily ward stock is calculated on the basis of 24 l~ours
requirement. And this agreed ward stock is replenished every morning by the
staff of central linen room.
iii) Exchange Trnlley System
To avoid handling by too many people in many of tlle hospitals in USA, average
daily stock of linen is supplied to the concerned hospital area and the linen is
replacedhy another trolley the next day.
iv) Pack Systeni
I

,
I
In this system, linen packs (full set of requireb linen flor one patienl) are prepared
in the linen room, and in a trolley these packs are distributed everyMay 40 eacp
I
!
ward and patient care areas.
Support and Utillty Servfccs-1 2) Decentralised Linen Services

Under this system, the various units, wards, operatioll theatres etc. are allotted with
required quotas of lincn articles. Washing is done by the laundry. For the purjose of
linen exchanges, sister incharge of these areas se~idthe dirty linen to the laundry and
froln laundry the line11 comes back to these areas, after washing. In tliis system, linen
are labelled and are marked, to avoid missing and mixing with that of other areas.
Sister Incharges rtre responsible for storugc and maintenance oi' linen.
3) Mixetl Linen Service
In tlie mixed linen supply system, the special areas e.g. Operation Theatres, Private
Wards etc, are given required quality of sufficient linen and they run t11elinen supply
on thebasis of decentralisation, whereas rest of the areas follow centralised linen
supplies.

3.8.2 Linen Inventories

Itegular record of total quantities of clean and dirty linen, daily load, average daily
load, and of how Inany old and new linen are in circulation in hospital, sl~ouldbe
maintained.

3.8.3 Maintenance of Linen

Mairitena~iceof linen plays an ilnportant role particiilarly in a hospital. It should be
done riglit from the time of purcl~aseof linen to tlie condemnation.

Cllleck Your Progress 3

Enumerate the main laulidry processes.

3.9 ADMINISTRATIVE POLICIES AND

PROCEDURES
Every hospital should have a manual on its Unen and Laundry Services and it sl~ould
define in clear terms the policies atid procedures to hc followed. While developii~g
the manual tlle following points should be taker1 into consideration:
1) Collection and Despatch of Line ,
e CentraIisedSystem
@ Separation of Soiled and Fouled Linen
e Collection
Daily: from OT, ICU, CSSD, Labour Room

Alternate Days: from Wards

Timings, Routes of Tracrion etc.
2) Policy for Equipment
e IS1Standard Bquipments
c Annual Maintenance Contract
3) Training of S ~ l f f
6 Proper Handling of Machines

52 e Correct I-Iandling of Soiled/Infected Linen

 s Fire Safety Precautions
s Optimum Use of Detergent
4) Detergent Stock
~ d e ~ u aBuffer
t e Stdck
5) Washing Formula
6) Cooperative Systeni
7) Standardization of Linen
8) Quality Control

3.10 LINEN CONTROL

Linen Control Committee must be constituted to oversee tl!e linen control
progriimmc. Members of the committee sliould be chosen from those working in
Store,"Laundry, Purchiise Section, I-Iospital Managemtnt of the Ilistitution and having
experience of seleclion, purcllasing, use and handling of linen.
One of the lncmhers of lillk~lcolninittee offer IC laundry inust be sclectcd as inchi~rge
of Line11 ~ o n l ; o lProgramme.
Elements of Linen Control Programme

1) Linen Purchase: Adequale quzultity of good quality line11should he purchased iuid

made available in l~ospilalfor use.
2) Cctitralised Control of linen and laundry services generally ensures better coutrol
over Lhe laundry workers.
3) Proper locking of stock room and restrictio~lof number of persons hiiving access
to them.
4) Proper scaling of co~ltail~ersand bags during trimsit of linen from one urea to
another, ruld system of receipt at each stage.
5 ) Fixing of responsibility to stnff llolding the charge of linen in dil'fcrent :ucas
6) Consta~itand positive supervision at all Lhe stages of li~lencirculation.
7) Regular physical veritjcation to pinpoinl. Lhe extent and type of loss with proper
prevenrive action hy the administration.
8) Frequent i ~ l adequate
d condelnnation of litlcn articles.
9) Proper lnailitenance of all the records.
10) Proper security arrangements at the e w of 11ospitaI areas. Reductioi~of exits Lo a
lniilimutn level.

3.11 QUALITY ASSURANCE

0

Quality assurance programme should be developed, Some of the points to be c i h n

into consideration while developing quality assurance progrrimlne in hospital laundry
are presented in the form of questionnaire as given here under:
Organisation and Persolanel

1) Whetlier Llle hospital laundry is properly slaffed?

2) To whom llle laulldry manager is responsible aiid wlietlier tllc organisatiotlal
hierarchy is proper or not?
3) Proper layout, dressing room and rest room with toilel racilities for laundry
employees.
 iupporl and Utility services-I 4) Laundry workers-whether trained or not?

I
5) Working hours per weektper day.
6) Precautionary 'measures to prevent laundry accident.
Physical Plant and Equipment
1) Location of the lai~ndryin relation to the boiler room, steam pressure, source of
hot water, electrical capacity.

I
1';
2) Proper lighting with no glare and glaze.
3) System of ventilation ideal or not.
4) Whether steam is exhausted properly from laundry?

5 ) Disturbance due to noise and vibrations.

6 ) Daily work load (lb or kg) and the capacity of the plant.
7) Proper work-flow is maintained or not'?
8) Maintenance system (including preventive maintenance)-by laundry personal/by
engineerdby contractor it exists or not.
Linen Handling

1) System of delivering dirty, stained, infected and contmni~latedlinens to the

laundry. How is it marked for identification?

2) System of control-accounting for line11sent to the laundry, physical counting

when laundry leaves the floors and again when it is sorted. Record keeping is
proper or not?
Laundering Process
11 How is linen sorted for was11 loads?
2) Normal wash load and the length of time requiring to complete the washing
cycle.

3) Test conducted to adjust the washing formula to the actual condition of hardness
of water.
4) Steps taken to remove stains.
5) " How is the laundering of special fabrics, such as woolens and silks, handled?
What precautions are taken to prevent fading of drapes etc.

6 ) Time taken between the receipt or dirty liilen for laundry and stage when they are
ready for delivery.

7) At what points are damaged linens detected and mended'? Persoil responsible for
meuding.
Linen Control

1) What authority does the laundry lnmlager have in determining the quality and
quantity of linen to be purchased? Other deparlrnents are consulted before
purchase or not. What tests are done for durability before purchase'!
2) What inventory records are kept lor the linen in slores ;~ndin circulation?
3) Record to determine the length of service the linen gives. Is the linen marked of
the date it is put in service?
4) Total cost ol linen replacements per month. What part of this a~nountis
represented by worn and discartled linen and thcft? What is tile ratio of line11in
circulation to the number of beds in the hospital?
5) How is lean linen delivered a11d by whom, how often?
 6) In what areas of this hospital are coloured linens used? Is the laundry
responsible for the dying of linen?

7) How often is a physical inventory verific;ltion held?

8) What group of hospital employee are furnished uniform? Iiow often are tlicy
laundered? What procedure is followed in issuing these unifonns?
Sewing Room

1) Location in relation to laundry.

2) What iteins are stilchedlmade in tlie sewing room?

3) What type of ~nachineis found in the sewing room?

4) What means of marking 11ewlinen? At what places of the sheets arc aiarkings
placed?

5) Personnel employed and differentiation of lheir duties.

Costs

1) Wliat is totaI laurldry cost?

2) What is the respective distribution of laondcring costs to vlldious user

departments?

3) What faclors are used in determining laundry costs?

4) Policy of.faundering of personal litien olelnployees. At w1i:tt cliargc il' pcrsooal

linen of employees is 1;iundered.
5) Which of the laundry machities are deprecialed. What deprccii~lionsclicdulc is
followed?

6) What is the present valuiltion of the liospital laundry?

3.12 LET US SUM UP

In this unit you have learnt the important roles oT linen ar~dlaundry services in
coxitrolling cross infection, ensuring patierlls cnmi'ort and satisfacl.ion, good p~lblic
relation, and en1i;mcing elegancelaestl~eticlook of the wards in hospital.
" It-is also learnt that out of various types of laundry services, mechaniscd laundry
scrvice 11as emerged as tlie most preferred system of laundry which can renclcr tlcsired
service, expecled level of s;initation of linen at reasorlable cost parlicularly for higgcr
hospitals or smaller hospitals lhat could group together tr, sct up ccntraliscd
mechanised laundry scrvice.
Jain Cornmiltee and Rao Cornrnittee of unioll government cmpllasiscd tlie nccrl ol'
mechailised laundry service for hospitals. By propor plil~ini~ig,
orgunisalion of
Mechanised Laundry Service, and prlrsuing lluitlily assurance programtnc, Iio.;pi~al
mmngerslauthorities will be able to meet the desirccl linen ncetlo1' Ilos.l?~tal\.

3.13 ANSWERS TO CHECK YOUR PIKOCiRESS

Check Your 1'1-ogress 1 .
1) I-Iospital linen Incans all clothing made of cotton li~le~l,
wool or syntliclic l'ilbrics
which arc used hy the patients or for Iiirn.
2) a) 111-plan~system
b) Rental system
c) Con tract systcnl
Support ullrl Utility Services-I d) CO-operativesystem

Check Your IBrogress2

1) Six sets

i) One set for patient beds

ii) One set en-route to laundry

iii) One set in process in laundry
iv) One set ready for use
v) Two sets for active storage for work and use in emergency.
2) a) 10 sq.ft. per bed or 10 sq.ft. for 2.5 kg.

3) i) Trolley, ii) Sluice machine, iii) Boiler(s), iv) Washing machine, v) Hydro
extractors, vi) Drier (Drying tumblers), vii) Calendering machine, viii) Steam bed
press, ix) Electric Iron (Hand Press), x) Sewing machine, xi) Ironing table,
xii) Weighing scales, xiii) Fire Extinguishers, xiv) Air cornpressure for
calendering machine.
Chech Your Progress 3
a) Washing
b) Hydroextraction
c) Drying

d) Calendering, hot ironing, pressing or band ironing.

3.14 FURTHER READINGS

American Hospital Association, Chicago, U.S.A. (1960), Hospiful Laundry Manual of
Operution.
Brown, R.E., Hosjlital Laundries-In und Out Hospital Mattugement, Chicago, 1965
Vol. 99 No. 2.

H.M.S.O. ..
Central Health Services Council (1959), Hospi~alLur4ndr.y Arrangetnent.~,London

Iilstitute of Scieuce and Technology, University of Michigan U.S.A. (1966),~Uospitul

SruJfing Mefhodo1og.y Munual-MM 2 1,aundry.
Kupuswami, T.N., Ho.~pitalLu~dnrlry,Selectio~lReading in Hospital Administration
1990.
Macualley, E1.M.C. el ul., Hospital Planning Adnzinistration, WHO,Geneva, 1966.
McGibnoy, Principul 0.f Hospital Adnaini.strution, 2nd Ed. 1969, Putnam's Sons, New
York.
Porrall, V.M., Sotne Special Considerution itz Purchasing Textile Hospital, JAHA
1963, 3757.
Pousssud, R,P., Hospital Laundries-In and Ordt Hospital Manugemenl, Chicago,
1965, Vol. 89, No. 2.
Sinha, R.P., Hospital Linen and Laundry Buckgro14izr1, Paper of Departinenl of
Hospital Administration, AIIMS, 1983, New,Delhi.
U.S. Department of Health, Educatiol~and Welfare, "Public Health Service"; The.
Hospital Laundry, vaghingion D.C. (1966).