Linen Management
in Hospitals

Why Linen Management Matters for NABH

Hospital linen is a potential vehicle for cross-infection if not managed correctly. NABH standards require hospitals to have documented policies for linen management covering collection, segregation, laundry, disinfection, storage, and distribution. Poor linen management is a common finding during NABH support services assessments.

Linen Flow – One-Way, No Cross Contamination

NABH requires a one-way linen flow to prevent cross-contamination between clean and soiled linen. The correct flow is: Patient Area → Collection → Segregation → Laundry → Washing and Disinfection → Drying → Folding → Clean Linen Store → Distribution.

Clean and soiled linen must never cross paths. Separate trolleys, routes, and storage areas must be maintained for clean and soiled linen at all times.

Three Categories of Linen Segregation

1. Clean Linen

Unused and freshly laundered linen. Must be stored in a clean, designated linen store away from patient areas. Must be covered and protected from contamination during storage and transport.

2. Used Linen

Used but not visibly contaminated. Collected in linen bags in patient areas. Must not be shaken to prevent aerosol spread of microorganisms. Transported in covered trolleys to laundry.

3. Soiled / Infected Linen

Contaminated with blood, body fluids, secretions, or excreta. Must be collected in leak-proof bags, clearly labeled. Staff must wear PPE (gloves, apron) when handling. Transported separately from used linen.

PAR Stock Calculation for Hospitals

PAR (Periodic Automatic Replenishment) Stock is the quantity of linen required to ensure uninterrupted availability across all units simultaneously. NABH expects hospitals to maintain adequate PAR levels to prevent linen shortages.

Recommended PAR Levels: 3-4 PAR

• 1 PAR — In use with patients
• 1 PAR — In laundry process
• 1 PAR — In clean linen store
• 1 PAR — Emergency / reserve stock

PAR Stock Example – 100-Bed Hospital

Actual requirement varies by specialty, occupancy, ICU/OT load, and laundry turnaround time.

Key Practices for NABH Linen Compliance

• Daily linen change in ICU, OT, and isolation areas — minimum
• Change immediately if soiled regardless of schedule
• Maintain linen inventory register with daily entries
• Use covered trolleys for transportation of all linen
• Staff must wear PPE during soiled linen handling
• Laundry temperature for disinfection: 71°C for 25 minutes or 65°C for 10 minutes
• Document linen losses and damages monthly
• Annual linen audit against PAR stock levels

NABH Linen Management Documentation Requirements

• Linen Management Policy and Procedure
• Daily linen inventory register (department-wise)
• Laundry temperature monitoring records
• Linen loss and replacement records
• Staff training records for linen handling
• Linen audit reports (quarterly recommended)

Frequently Asked Questions

What is the minimum linen change frequency for NABH ICU?

NABH and infection control best practices require daily linen change in ICUs. Linen must be changed immediately if soiled regardless of the daily schedule. Pillow covers and draw sheets in high-dependency areas should be changed with each patient or when soiled.

Can a hospital outsource laundry and still be NABH compliant?

Yes. Hospitals can outsource laundry services. However, the hospital must have a documented agreement with the laundry vendor specifying quality standards, disinfection temperatures, turnaround time, and segregation protocols. The vendor must be periodically audited as part of the hospital's supplier management process.

What PPE is required for linen handling?

For used linen: gloves minimum. For soiled/infected linen: gloves, apron, mask, and eye protection as appropriate. Staff must be trained in safe linen handling practices and PPE use as part of the hospital's IPC programme.