Healthcare laundry is often underestimated, yet it plays a critical role in infection prevention, patient safety, staff protection, and linen longevity. Poor laundry practices can contribute to cross-contamination, damaged textiles, chemical exposure, and unnecessary operational costs. During audits, several recurring mistakes continue to appear across healthcare facilities. 

Lack of segregation 

One of the most common failures is the lack of segregation between clean and dirty workflow areas. Soiled linen should move through a one-way process from collection to washing, drying, finishing, storage, and distribution. When dirty and clean linen cross paths, the risk of recontamination increases significantly. 

Improper handling of infection linen 

Another frequent issue is the improper handling of infectious linen. Linen contaminated with blood, body fluids, or from isolation patients should be placed in leak-proof or water-soluble bags as per facility policy and risk assessment. However, many facilities still transport wet or contaminated linen in ordinary bags, increasing the risk of leakage and staff exposure. 

In wards and soiled utility rooms, it is common to see linen hamper bags lying directly on the floor. This creates contamination risks and poor housekeeping conditions. Hampers should be supported on designated trolleys or stands and cleaned regularly. In addition, dirty linen bags are often overfilled beyond three-quarters capacity, making them difficult to close safely and increasing tearing, spills, and manual handling injuries. 

Using old technologies and equipment 

Equipment problems are another concern. Many facilities continue to use old washing machines without automated monitoring systems for time, temperature, dosing, and cycle validation. Without these controls, there is no assurance that disinfection parameters are consistently achieved. Equally concerning is the absence of monitoring records such as wash temperatures, cycle completion logs, maintenance checks, and calibration reports. 

Weak chemical management 

Chemical management is often weak. Some laundries use detergents, alkalis, bleach, neutralizers, or disinfecting chemicals without reviewing manufacturer instructions for use, especially for surgical textiles, microfiber products, flame-retardant fabrics, or barrier gowns. Incompatible chemicals may damage linen fibers, reduce absorbency, fade colors, weaken barrier performance, or shorten linen lifespan. 

Staff competency 

Staff competency remains a major gap. Laundry workers are sometimes not trained in correct wash formulas, PPE use, chemical dilution, spill response, emergency eyewash procedures, and safe handling of sharps accidentally left in linen. Exposure to concentrated chemicals or hidden sharps is a real occupational hazard. 

Additional common mistakes include inadequate separation of clean linen storage from chemicals or waste, poor ventilation in laundry rooms, failure to clean carts and transport trolleys, delayed processing of soiled linen, mixing personal clothing with healthcare textiles, and storing clean linen uncovered in dusty areas. 

Healthcare facilities should also monitor water quality, dryer temperatures, residual moisture, and linen repair/replacement rates. Preventive maintenance and routine microbiological or process verification may be considered based on risk. 

Healthcare laundry is more than washing fabric—it is a controlled decontamination process. Strong policies, trained staff, validated equipment, proper chemical use, and continuous monitoring are essential to ensure linen returned to patients is hygienically clean, safe, and fit for purpose. 

About the author 

Noel S. Gonzaga, BSMT, MPH, AMT, RMT, CIC is a distinguished healthcare professional from Ministry of Health, Oman.