Since every hospital employee has a responsibility to protect the monetary assets of the facility, end users need to apply the concept of “rational consumption” to hospital linen.
They need to regard linen as a consumable medical supply with an associated cost per use, make conscious decisions about investing each linen item during patient care, and understand the fiscal implications of doing so.
When it comes to healthcare textiles, more isn’t necessarily better and using more linen items than are necessary can actually impact patient care in a negative way.
A common example of linen overkill is the layering of linen products under the patient, which nursing staff can mistakenly believe will contain incontinence more effectively or provide a more comfortable sleeping surface.
The reality is that the extra layers create added pressure between the therapeutic mattress surface and the patient’s skin and contribute to potential skin breakdown.
Another “irrational” linen practice is using products for reasons for which they weren’t intended. A common example of inappropriate product use is using a bath blanket in place of a draw sheet as a lift device.
Blankets are designed to trap warm air from the patient’s body within the fiber spaces, much like a sweater. They are also “stretchy” like a sweater, which means that the fibers can stretch under the weight of a patient.
Bath blankets are also put through a combing process called “napping,” which uses a steel comb to cut across the fibers to pull them up and make the blanket fluffy. This process gives the blanket a softer feel, but weakens the fibers. Consequently, a bath blanket is twice as heavy as a draw sheet and half as strong. An examination of old bath blankets will often reveal the sides have become stretched out of shape from lifting patients.
The time-honored materials-management principal of “the right product, for the right reason, at the right time, in the right amount” should govern end-user attitudes toward linen and all other consumable medical supplies.
Here’s a brief summary of ways linen end users can participate in rational consumption:
— Adhere to the hospital bed make-up and linen change policy.
— Become a member of the linen task force or linen committee.
— Use the rag-out/discard bag for clean, unused, torn or stained linen.
— Adhere to standards and guidelines of OSHA, APIC, AORN and other regulatory agencies.
— Take into the patient’s room only the linen that is immediately needed.
— Remove all tape and adhesives from linen before putting items in the hamper.
— Undo all snaps before placing gowns in the soiled-linen bags.
— Use rags, not washcloths, to clean up spills.
— Return the scrubs you have at home.
— Use disposable and reusable underpads together, or layer them under the patient.
— Use a bath blanket as a lift device.
— Put a draw sheet under a reusable underpad. The underpad is a competent positioner.
— Hoard linen in unauthorized stocking locations.
— Use hospital blankets for staff warmth. Bring a sweater or warm-up jacket.
— Throw linen in the trash or put in red bags.
— Write on scrubs or any other linen item; ink doesn’t usually wash out.
— Cut linen items, such as patient gown sleeves or ties.
— Allow paramedics to take the hospital linen.
— Allow patients or visitors to help themselves to linen.
The action plan discussed in Part Three is a detailed method of developing and implementing strategies for preventing losses and for tracking progress. However, it’s still necessary to establish measurements for the results of your actions in order to understand the degree to which they have been successful.
The most general measure of success would be a decrease in the number of replacement items purchased by individual product. Another measure would be an increase in the amount of soiled linen being returned to the laundry for processing. Yet another measure would be a decrease in losses by item between physical inventories.
It’s important to make sure that any linen loss campaign include a measurement step and that the results of the hospital’s efforts be shared with staff to encourage their continued cooperation.
Although all hospitals must contend with linen losses, losing linen should not simply be accepted as the cost of doing business in a medical facility.
Linen is a valuable hospital asset and the “whys” and “hows” of its use and loss have a significant impact on the financial health of the hospital. Therefore, every effort should be made to put programs in place that will help protect this valuable hospital resource, just as other medical supplies and equipment are protected from theft and abuse.