Protocol for dirty linen?

[NRuiz]

Hello there,

I hope you are all having a wonderful day or night, whatever time it may be :)

I just wanted some insight about something. I am a CNA who has been working on a med/surg floor for several years now, and am curious about something.

When changing a patient who has messed the bed, it is common for the nurse or aide to toss the dirty linen to a pile on the floor, rather than having a linen cart in the room and putting it directly inside. This has always made me somewhat uncomfortable and I try to bring the cart in with me and use it appropriately. However, I've noticed that this is not a common practice; the floor piles are. After the change is done, the pile is picked up and carried to the cart.

This is how I was shown, and nothing has been said about the exact protocol in linen disposal, and I was just wondering if this is normal in other hospitals too? Any thoughts? Thank you!

[RainMom]

Common? Unfortunately yes. Correct? Absolutely not! When I first started, we had linen bags hanging in the bathroom that made it kind of hard to refrain from making a pile during changes rather than making several trips to the BR. What I would do is put down a clean peripad on the floor to put dirty linens on top. We have since changed to large garbage cans that can be moved to bedside with a footpedal to make it hands-free & I've seen less dirty piles by staff.

[nurseprnRN, BSN, RN]

"Piles on the floor" is a bad practice from several standpoints. Good for you for thinking about this.

1) Fecal material is now on the floor, either directly or via strike-through of wet washcloth/towel/sheet, ready to be tracked all over the place by shoes and wheeled equipment.

2) Someone has to bend over and pick up that pile, making it easy to contaminate arms, hands, hanging stethoscopes, name badges, keys, hair, and clothing. Also a needless exposure to potential back injury.

3) That pile has to be carried somewhere else, increasing the chances of contaminating other spaces/rooms/halls

Ask your infection control nurse to pull up the best practices on this and do an educational offering about it. S/he can also out some pressure on the powers that be to provide safe receptacles for dirty linens at bedside or easily brought there, enough to serve the needs of the floor.

[havehope]

Being that our linen carts are in the bathroom, it is simply impossible when you are by yourself handling a patient that say, can't stay turned on one side to be changed for so long. So, what I do is put a few clean towel down on the floor and then put the soiled linen on top of that. I would love to hear others input for new ideas that are realistic and cleaner. :)

[ChristineN, BSN, RN]

Being that our linen carts are in the bathroom it is simply impossible when you are by yourself handling a patient that say, can't stay turned on one side to be changed for so long. So, what I do is put a few clean towel down on the floor and then put the soiled linen on top of that. I would love to hear others input for new ideas that are realistic and cleaner. :)[/quote']

Why wouldn't you just wheel the cart out of the bathroom before you start cleaning up your pt?

[havehope]

Why wouldn't you just wheel the cart out of the bathroom before you start cleaning up your pt?

Some roll and some do not. If they roll I try to remember to put it by the bed.

[JDZ344]

It shouldn't be done, but in my experience it is done often. If I know I am going to change the patient, I take the linen cart. For patients who are incontinent a lot, I keep a roll of linen bags in the room with them so I can just grab one and put the linen in that.

[Esme12, ASN, BSN, RN]

Some roll and some do not. If they roll I try to remember to put it by the bed.

and if they roll...they don't stay open so you can place the linen in them....if you are by yourself you can't leave the patient to open it.

Hospitals claim they want good practice yet do not always supply the means to do so.

I do the clean bath blanket/spread on the floor as well.

[havehope]

and if they roll...they don't stay open so you can place the linen in them....if you are by yourself you can't leave the patient to open it.

Hospitals claim they want good practice yet do not always supply the means to do so.

I do the clean bath blanket/spread on the floor as well.

Thanks Esme, glad I am not the only one that admits they do it when there is no other option. Sadly, most of the time when they do roll and you try to drop linen inside, the bag falls out onto the floor because it's too much linen…if this makes any sense.

I had a patient ask me awhile back if we had "brand new" washcloths and towels, where no other patient had ever used them. Of course we don't. But, she made a good point. I couldn't imagine wiping my face on some of the washcloths I have put in the dirty linens.

[NRuiz]

Thank you guys for your responses, a part of me is a little uncomfortable about being a "whistleblower" but it isn't worth it to risk the infection to everyone! I'm going to bring it up to infection control/education and see if we can get a more enforced policy in place. We do so much to keep our hands clean and things such as countertops and computers and what not clean, and I know the floors are cleaned by housekeeping, but not enough to keep up with that practice of "floor piling" during cleanups. ESPECIALLY in isolation rooms!

I too do the whole clean towel/bedpad on the floor technique if no linencart is available, but have found that when changing with another aide or nurse and a linen cart is in the room, they will still toss linens on the floor!

[NRuiz]

I am glad to hear I am not alone and also that it isn't just my hospital that does this I had a feeling that it was a normal practice between facilities...now time to make some changes!

[NRuiz]

Thanks Esme, glad I am not the only one that admits they do it when there is no other option. Sadly, most of the time when they do roll and you try to drop linen inside, the bag falls out onto the floor because it's too much linen...if this makes any sense.

I had a patient ask me awhile back if we had "brand new" washcloths and towels, where no other patient had ever used them. Of course we don't. But, she made a good point. I couldn't imagine wiping my face on some of the washcloths I have put in the dirty linens.

It is both gross and fascinating how they can disinfect and clean those gross little poop rags! When people tell me they think my job is gross, I always respond with...imagine being the person who works at the laundry facilities that take the linen! Between the soiled linen and the chemicals that they use, it must be a stinky, stinky place.