This week on the CMSCG Blog, we are continuing to delve into the Infection Prevention and Control regulations that are part of the Requirements of Participation. In our last two posts, we provided an overview of the other requirements under F880, and this week we will specifically look at linens.
The Interpretive Guidance (IG) provides several pages worth of information on linens beyond the basic regulatory requirement at F880 that nursing facility staff must handle, store, process and transport linens in a manner that prevents the spread of infection. Staff should handle all used laundry items as if they were potentially contaminated and use standard precautions, but the IG also provides information on how separation and identification of linens should be conducted. When transporting laundry, staff should not hold contaminated linens/bagged contaminated linen near their own bodies or squeeze them to avoid contamination of air, surfaces or personnel. Additionally, the facility must have policies and practices in place that address the storage of linens regarding use of covers and separation of clean and contaminated linens as well as proper linen storage.
Linen handling is a good target for surveyors to observe for deficient practices since it is easy to see staff holding linens against themselves or an uncovered linen cart being used to transport clean linen However, the laundry room itself is also an area that is ripe for potential citations. Examples of what surveyors looks for during a visit to your laundry include availability of hand hygiene products and PPE; clear separation of clean and contaminated linen areas, if you use fans in the laundry processing areas which way the ventilation is flowing, maintenance of laundry equipment being used and maintained per the manufacturer’s instructions for use to prevent “microbial contamination of the system” to name a few. Here are a few examples of how this has been cited under the LTCSP:
- A surveyor observed the laundry room at a facility that did not have available protective goggles, gowns and disposable gloves for staff to use.
- After watching a staff member folding clean linens, a surveyor interviewed her about handling of soiled linens and the employee told the surveyor that there is PPE available for their use, but the apron gets in the way of her loading the washing machines so she didn’t always wear it, nor does she wear the available mask.
- Surveyor observed multiple bags of soiled laundry under the chute backing up into the chute and as he stood looking at the chute, “brown matter flew” from unbagged soiled laundry onto the floor.
- The handwashing sink in the laundry room was not working so staff had to leave the laundry chute room to use the sink in the bathroom across the hallway.
Remember, a single observation here and a single observation there can be tied to together and equal a deficiency.
If you missed Part 1 and Part 2 of our Ftag of the Week coverage on F880 Infection Prevention and Control, you can review them here. You can also look at CMSCG’s Ftag of the Week for F881 Antibiotic Stewardship Program here. We’ll continue our coverage of Infection Prevention and Control over the next couple weeks with a look at F883 Influenza and Pneumococcal Immunizations and F882 Infection Preventionist. Stay tuned.