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Spotting (and solving) laundry problems. (Feature Article).

Ecolab Shared Technical Service has 20 specialists who answer questions that clients, including nursing homes, pose to Ecolab's field associates about their laundry problems--as well as other housekeeping and cleaning challenges. The topics of the laundry questions we receive most frequently are stain removal, odors from incontinence (both fecal and urine) and bacteria control.

This article will address these frequently asked questions, as well as the most common mistake made in on-premise laundries: the overloading of machines.

Out, Out, Darn Stain!

Stains are a major challenge in nursing homes because of the diverse classifications of stains a healthcare laundry encounters. Contrary to what you might have seen on television, there are no miracle stain removers that work equally well on all stains. Healthcare facilities produce linen stains from a variety of operations. For example, the dietary department produces stains from food supplements and additives, in addition to the usual food stains from grease, oil and whatever is on the menu for that day.

The most difficult stains to remove are those related to nursing. Stains from medications such as Betadine, Granulex, Hibiclens, etc., and even vitamin supplements, can be very difficult to remove if not handled properly. Often, such "specialty" stains will not come clean during the "normal" washing process and will require specialized "stain-removal" products. Because each of these stains is unique in how it needs to be removed, the first step is to identify the source. It is often easier to get rid of the source than to get rid of the stain. For example, when possible, using a different medication or supplement, with different ingredients, often solves the problem. If that isn't possible, once we identify the source, we can recommend the best product and procedure for removing it.

What's That Smell?

When reusable diapers and pads give off odors, there is a very good reason: They're not clean. This problem is especially common with laundries that have "fixed timer" washing machines, but it can also occur because the proper cleaning supplies haven't been used, or the proper amounts of supplies dispensed.

Five basic factors produce clean laundry: time, temperature, mechanical action, procedures and chemicals. When clients complain of "smelly" incontinence reusables, the following steps should be reviewed:

* Make sure water levels are adequate to provide proper rinsing and dispersal of all chemicals.

* Be sure employees aren't overloading washers.

* Check water temperatures. For detergents (alkali) and bleach, the optimum temperature range is 150 to 160 degrees. Quality will be lost at lower temperatures.

* Make sure rinse and flush cycles are adequate. As mentioned earlier, this is a problem with fixed-timer washers, because they have predesigned formulas that can't be altered, except for extending the time of a particular cycle. On these machines, we cannot add additional rinses and flushes, nor can we add additional detergent or a bleach bath to aid in soil removal. The best possible solution when using fixed-timer machines is to add a "chart stop" device to the machine, which stops the timer at certain times during the detergent/suds cycle to aid in cleaning.

Getting the Germs Out

Clients often ask, "Can I add a disinfectant to my laundry machine to help disinfect the linens?" The answer is a resounding "No!" If you look at the label of any sanitizer or disinfecting product's container, it will say that "...to use [it] in a manner inconsistent with its labeling is a violation of federal law." Therefore, these products cannot be used to disinfect laundry. In fact, even laundry bleaches can't be claimed to be disinfectants in the wash wheel, even though they undoubtedly kill bacteria at certain levels. And although there are products on the market that are EPA-registered as "bacteria inhibitors," they are not designed to kill bacteria in the wash wheel, but to help inhibit the growth of bacteria after washing and drying.

The Centers for Disease Control and Prevention (CDC) recognizes the entire laundering process--as it pertains to institutional machines--as being effective at eliminating bacteria, as long as certain factors are achieved: sufficient rinsing and flushing of all soiled linen; a high and low pH range achieved during the detergent and "sour"/neutralizer cycles; the correct concentration of the bleach bath; and washing and drying temperatures.

Watch Your Weight

Overloading laundry machines is a huge problem in nursing homes. Many years ago, laundered items were agitated on a "scrub board," which provided mechanical action to help loosen soil. Today, the mechanical action is provided in an institutional washer as the wheel rotates clockwise and counter-clockwise and the linens in the machine fall against each other from the top of the wheel to the bottom. This mechanical action is lost when machines are overloaded.

Overloading also inhibits the flow of water through the fabrics and around the wheel as it rotates. This flow of water is needed for the cleaning process, particularly for ample rinsing and flushing, which are vital for the removal of free-floating, water-soluble soils. Finally, overloading of washers hinders the proper dispersing of cleaning chemicals and can lead to chemical stains and burns.

Choosing Your "Weapons"

Another facet of managing the laundry involves choosing from among the various detergents on the market today--powders, liquids and solids--based on their advantages and the type of laundry being cleaned.

Powdered detergents--and other powdered chemicals--are less expensive than liquids and solids, if they are used properly. In other words, the amount of product added to each load must be tightly controlled and consistent. The problem is that this often isn't the case, which is why automatic product dispensers have become so prevalent.

Most powders require hot water to dissolve properly. They will dissolve in warm or cold water, as well, but not necessarily quickly enough to be effective, because detergents (and other chemicals) need to be activated in the wash wheel immediately, especially if a machine is programmed for a short wash cycle. If you have, for example, only a six-minute wash cycle and it takes three minutes for the detergent to dissolve, you will have a cleaning issue. That is not generally the case with liquids or solids. Another drawback with powdered products is that if they aren't thoroughly dissolved they can become imbedded in the fabric and cause burn holes or even skin irritation.

Liquids are the most commonly used form of detergent (and other chemicals) on the market today. They are used in everything from the smallest "homestyle" machine to the large-volume "tunnel" washers. Unlike powders, they become active in a very short time after being injected into the wash wheel, regardless of water temperature. (The one exception is liquid fabric softener, which tends to gel in cold water.) Most liquid products are dispensed via an automatic pumping system.

Further enhancing the performance of liquid products, a number of systems on the market today allow programming for different amounts of each product to be dispensed, depending on the type of linen and soil load. For example, bedspreads and blankets are generally lightly soiled and don't require as much detergent as diapers.

There are two basic disadvantages to using liquid products. First, some liquids--especially bleach--are highly corrosive and can damage washers if not properly injected. Water flushing systems, commonly referred to as "flush manifolds," can help to solve this problem. Second, there is a danger of chemical damage to linens. Liquid chemicals injected full-strength into the wash wheel have the potential for coming into contact with fabrics and leaving burns or stains; this is particularly so when chemicals are injected through the top of the machine, when water levels are too low or when the machine is overloaded.

Solid laundry products have made a big impact over the past decade and are growing in popularity. One of their advantages is packaging size. A typical 5-gallon pail of liquid laundry detergent weighs approximately 60 lbs, compared with a typical capsule of solid detergent, which weights 7 to 9 lbs. Thus, solids are much easier to handle and require less storage space.

Another advantage of the solid products is that when they are injected (pumped) into the machine, they are already mixed with water; therefore, because a raw chemical isn't being pumped directly into the wash wheel, there is far less potential for chemical burns or stains. Also, the possibility of an employee coming into contact with a dangerous chemical is far less than it is with powders or liquids, because the solids are generally enclosed in a plastic capsule that is placed directly into the dispenser.

One note of caution regarding choosing laundry detergents and other chemicals: The types made to be used in institutional machines are not suitable for "home-style" machines, which are often used in nursing homes for small or lightly soiled loads. These smaller machines typically have a porcelain lining that cannot handle institutional types of detergents and other products.

"Enviro-Friendliness"

An additional factor to consider in choosing laundry products is their impact on the environment. There are two main ingredients in institutional laundry products that affect the environment: phosphates and surfactants. Some states (e.g., New York) already have strict limitations on the use of phosphate-containing products. Most chemical companies are making products available to meet emerging environmental standards, and we are seeing a broader selection of available nonphosphated (NP) products. This environmental consciousness comes at a price: Nonphosphated detergents don't clean as well as phosphated ones.

The use of surfactants, such as nonylphenol ethoxylate (NPL), is beginning to be limited. Canada is in the process of prohibiting the use of NPL within its borders, and some states in the U.S.A. are also taking a close look at limitations.

Another environmental (and cost) concern is the amount of water used in the laundry. Much of the soil encountered in a nursing home is water-soluble, so much of it can be rinsed away during the preflush (a cycle programmed at the beginning of the wash process, in which the machine fills to a high water level with no chemicals and flushes out these soils before detergent or any other chemicals are added). If we do not preflush as much of these soils as possible before the suds bath, more detergent and/or bleach are needed to get the laundry clean. This translates into higher chemical costs and leads to more linen degradation and, thus, higher linen replacement costs.

A better way to approach a water-savings program is to be sure to use only those formulas that use as little water as possible for the soil/fabric you are washing. Another way to save water is to eliminate unnecessary steps, if possible. And don't use "generic" wash formulas on everything. This is a big waste of water.

Jim Mitchell is a technical support specialist at Ecolab Shared Technical Service.
COPYRIGHT 2002 Medquest Communications, LLC
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Author:Mitchell, Jim
Publication:Nursing Homes
Geographic Code:1USA
Date:Feb 1, 2002
Words:1791
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