Disposing linens of TB patient

[chenoaspirit, ASN, RN]

I was just wondering about something. At the hospital I work, when a TB patient needs a linen/gown change, nurses/assistants just take the dirty linens into the hallway and dispose with other linens in the dirty laundry hamper. Doesnt that pose a risk to others? I mean, shouldnt they be placed in the red bags for careful handling and to protect anyone else in the hallways? TB patients have to be placed in airborne precautions and everything in the room is contaminated. I just dont feel comfortable carrying these items into the hallway and placing them into a container that housekeeping will have to touch and patients have to walk past. Anyone have any insight? Also, I have had patient loads consisting of babies and TB patients, babies and bacterial meningitis patient, etc. I tried discussing this with the charge nurse who makes these assignments, but of course she knows best and Im the dumb one. I would rather either have all the babies or all the TB, MRSA, Mengitis patients and protect the immunosuppressed, etc. Am I off base here? But Im really curious about the disposal of the linens.

[mom2michael, MSN, RN, NP]

I did clinicals at at TB facility and linens were mixed in with the rest from the hospital - they were not labeled any differently. They cited the reason is, they treat all linens as potential haz. to anyone involved in the handling of them from dirty to clean. They have all kinds of patients at this place too, not just TB patients.

We very rarely red bag any linens because in my facility - that means they must be disposed of in a bio hazard dump site and not cleaned which is very expensive. We used to have blue bags for haz. linens and white for the rest and now we just use white for them all except our oncology floor where all their linens are bagged yellow.

[Lacie, BSN, RN]

I agree with the previous poster. Not sure where in Ky you are but I was also in a small rural hospital in Eastern KY where we did have infants, children and adults in the same ICU at times. We did have pts with TB as of course there is quite a prevalence of it in those areas. Although the pt may be in an isolation room we treated all linens the same as everyone elses not afflicted with the disease. Using universal precautions then there shouldnt be an issue. I was not from KY but it didnt take me a year of working in the area that I turned a positive test myself. Exposure but not active and required taking INH/b-complex for a year. My son also tested positive and had to undergo prophactic treatment. Just remember good handwashing techniques, cleaning the stethoscope between patients etc.

[CarVsTree]

Since TB is airborne, I'm not sure how much risk the linens pose in the first place.

However, in our iso rooms linens are never brought out into the hallway. We order an iso kit and they get a disposable hamper. All linens are bagged before bringing out of the room.

[suzanne4, RN]

TB is transmitted strictly by the aorborne route. Once the droplets are on something, they are no longer going to cause an infection as you cannot breathe them in. Those patients are strictly on airborne precautions, not contact.

With any type of infection, always think route of transmission first. Hope that this helps. No reason for the linen from those rooms to be isolated.

[jojotoo, RN]

Maybe I need some clarification. I thought that TB was transmitted by droplet contamination, not airborne.

How are people infected for cutaneous TB? Direct contact with TB droplets? If so, we would need to use care in disposing of soiled linens.

[mom2michael, MSN, RN, NP]

Here is a link to cutaneous TB, which what I understood from the article is very, very rare.

Cutaneous tuberculosis (TB). DermNet NZ

I spent a great deal of time in a TB unit and for the most part the only precaution on this unit is airborne precautions, so they have their negative air pressure rooms with alarms if the doors to their rooms are open too long, you must wear a mask when you are in their environment, they wear one in yours, they can't leave the unit, etc.....Everything that comes in and out of that unit is treated like any other patient had contact with it - that inlcudes linens and meal trays. Those responsible for cleaning use standard precautions.

RN that I worked with during clinicals has been there for 22 years and they have used only airborne precautions the entire time she has been there and she has never tested positive for TB.