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TRSA Microbial Testing Gaining Notoriety

TRSA’s Hygienically Clean Healthcare certification is gaining attention because of its use of microbial-testing to help determine that laundry practices remove the risk of clean textiles contributing to hospital-acquired infections (HAIs), according to industry news releases.

The problem is that this emphasis on testing is overshadowing the standard’s rigorous protocols for quality assurance (QA), requiring inspection for initial certification and re-inspection to maintain it.

The Hygienically Clean protocol was developed in collaboration with commercial laundries and healthcare professionals. It combines the advice of subject-matter experts with a users’ group of certified facilities to identify and resolve hygiene issues. Regular microbial testing adds to the evaluation and maintenance of the certification.

The program’s thresholds ensure that textile products are free of pathogens in sufficient numbers to cause human illness. This specification is in accordance with standards established by the Certification Association for Professional Textile Services (CAPTS). Based in Germany, this organization has served 400 members in 15 European countries, Japan, China and United Arab Emirates. The microbial levels that CAPTS and the European Union currently permit for laundered textiles were established 30 years ago.

Statements issued on Feb. 8 by the Healthcare Laundry Accreditation Council (HLAC) and on Jan. 19 by the Association for Linen Management (ALM) indicated that Hygienically Clean relies solely on this routine screening of microbial content, avoiding discussion of the program’s QA protocols. That’s a mischaracterization of Hygienically Clean certification.

In fact, Hygienically Clean inspections verify laundry processes. The program’s microbial testing quantifies cleanliness, thus “providing a vital addition to ensuring that best-management practices (BMPs) are documented and followed for the production of hygienically clean textiles,” said TRSA Chairman Douglas Waldman. Between inspections, testing indicates changes in laundry processing techniques, particularly wash-chemical adjustments, added Waldman, president of Superior Linen Service, based in Tulsa, OK. All three of the company’s laundries are Hygienically Clean Healthcare certified.

TRSA introduced Hygienically Clean in 2012 to enhance existing protocols with an internationally recognized testing component. While Hygienically Clean has highlighted the testing component, testing has overshadowed the certification’s strong dedication to verifying that plant facilities, housekeeping and laundry processes follow applicable infection-control guidelines.

Clean textile products rarely are implicated in HAIs. It’s happened 12 times in 43 years, according to Vincent C.C. Cheng, MD, infection-control specialist at Queen Mary Hospital, Hong Kong. He and his team investigated a July 2015 fatal zygomycosis outbreak there, citing “microbiological testing as a solution” for issues with the hospital’s laundry supplier, such as separating clean and soiled linen, proper storage at the laundry and machinery maintenance. This analysis supports TRSA’s Hygienically Clean combination of process protocols, inspection and ongoing testing. Dr. Cheng went on to recognize Hygienically Clean’s threshold for microbial content as “the U.S. healthcare textile certification requirement.”