I have been in the healthcare laundry business for more than 32 years and have always worked on the institutional side. During my career, I have taken great pride in operating an efficient, high-quality laundry.
I have read many articles about how the commercial side of the business is looking to target my market and shut down all the in-house and small, central laundries. The threat has always been there, it has been real, and yet, my laundry has survived.
One of the reasons that I continue to survive is my willingness to go aggressively where a number of commercial laundries dare not tread.
I realized back in 1980 that in order for a healthcare laundry to justify its existence, it needs to embrace a number of reusable linen items that offer improved patient care at a reduced cost. This philosophy caused me to add reusable incontinent pads and a reusable barrier surgical line to my operation.
I understood early on that if I was to be successful in supplying reusable surgical linen to a facility, the linen would need to be folded, inspected and packaged at the laundry. I had to supply a reusable item that was as convenient to use as its disposable counterpart.
One reusable item that I believe could become a major item for any healthcare laundry is the lowly isolation gown. To meet today’s standards, this item must be fluid-repellent all the way around. It should be designed or processed so as to avoid static-electricity buildup, it must be comfortable for the end user, and it needs to hang well.
I have used reusable isolation gowns for more than 10 years and have found that, if processed properly and packaged conveniently, the item can be a big hit with the hospital staff.
I have always stocked two sizes: LG/XL and 3X. These sizes allow me to cover all the staff members who are required to wear personal protective equipment while doing their regular care out on the floors. When I first introduced this item in Milwaukee, I was amazed at the demand. I went from using no reusable isolation gowns to supplying more than 40,000 uses in the period of a year.
The key to making the item work is in the processing. Like all new-generation polyester barrier linen, you must clean the product without leaving any residual soap in the fabric. Such residue decreases the fabric’s barrier properties and can enable moisture to pass through it. This is a case where using the least amount of laundry chemicals is best. When I wash these items, I use very little alkali, a small amount of a solvenated detergent, no bleach, no softener and just a little sour.
It is important to remember in washing this style of linen that none of your chemicals or the wash liquor will become sequestered in the fabric. It all remains in solution and ready for use. It is also important to remember that high levels of alkalinity damage the water-repellent finish.
Because the material is so lightweight, I believe it is necessary to underload the washers in order to get proper mechanical action. Depending on what company manufactured your washer, you can expect to load between 60% and 70% of the rated capacity for regular poly-cotton linen.
My washer of choice is an open-pocket model with a glass front door. This allows me to watch the mechanical action as it occurs. If the washer is too underloaded, the material will float and get little mechanical action. If the washer is overloaded, the material will simply go around in a ball, also with little mechanical action.
There is a small range between too little and too much mechanical action. Each laundry manager must determine what that range is for their specific equipment and product mix.
I have become a strong advocate for barrier fluid replenishers that are used in the wash wheel. I have been able to prove, by using a Sutter hydrostatic tester, that this type of product eliminates the gradual decrease in fluid repellency that is inherent in all polyester barrier fabrics.
The replenishing material is added to the last rinse of the wash cycle and cures in the drying process. I have been able to process isolation gowns 100 times with no loss of fluid repellency from the first processing to the last.
This type of product becomes the keystone of any quality-control program involving barrier linen. Manufacturers of disposable or single-use isolation gowns are well aware of the problems associated with improper processing of reusable barrier material.
In my travels I have seen yellow polyester barrier gowns that were processed in such a way that they virtually turned white. It was obvious to me that the fluid repellency of that fabric had been lost.
We laundry managers must be prepared to defend our reusable product’s viability against the questions raised by our competitors. We must be able to ensure the end users of our product that the barrier protection will be there for each use. Failing to establish a working quality-control program will result, sooner or later, in the failure of the product and loss of the business.
Take care when drying the item. Polyester barrier items are subject to heat damage and must be dried at a lower temperature than other linen items. The good news is that they dry quickly at almost any temperature.
The perfect dryer to use on this type of linen is a steam dryer. Because of the fabric’s lightweight nature, it is recommended that the dryer be set to reverse during the drying cycle to avoid having gowns plastered against the drum for long periods of time.
The final trick in making this product user-acceptable is the way it is packaged after it is folded and inspected. Because the gown feels silky, it is difficult to stack and keep on a linen cart. To deal with this issue, I asked my suppliers for help and they came up with single-use shirt boxes made from recycled paper.
I am able to put 10 gowns into a large shirt box that opens on the end. The box acts as a dispenser and keeps the gowns nice and neat on the carts. This delivery method, along with the proper processing procedures and a good quality-control program, makes this item a staff favorite.
I believe establishing a quality-control program for reusable barrier textiles is a key to a healthcare laundry’s success.