The Dirty Truth about Sluicing: Part 2

For decades, the traditional sluice room has been a fixture in aged care facilities across Australia and New Zealand, serving as a necessary, albeit unpleasant, space for handling soiled linen. However, a critical question now arises: is this outdated practice, full of unseen risks like aerosol generation and cross-contamination, still justifiable in modern aged care environments? The answer, strongly supported by significant advancements in technology, evolving industry standards such as AS 4146:2024 (Laundry practice) and NZS 8134:2021 Ngā paerewa Health and disability services standard, as well as strict legal obligations under Australia and New Zealand's Health and Safety at Work laws, is a resounding no. It's time to close the door on manual sluicing and embrace a safer, more efficient, and compliant future for laundry management that protects both staff and residents.

For decades, the sluice room has been a standard feature in aged care facilities, serving as the space for the necessary yet unpleasant task of manually rinsing soiled linen. However, with significant technological advancements and a better understanding of infection control, it's time to ask a crucial question: is this outdated practice putting our staff and residents at unnecessary risk? The answer, supported by new standards and legal obligations, is a definite yes. It’s time to move on from the traditional sluice room and adopt a safer, more efficient approach to laundry management.

While seemingly a routine task, manual sluicing presents significant health and safety risks. Recent facility observation reports pointed out that the process produces aerosols, tiny airborne particles capable of carrying pathogens and contaminating nearby surfaces, equipment, and even clean laundry bags stored nearby. This splashing and aerosolisation creates a high risk of cross-contamination, turning the very room intended for cleaning into a potential source of infection. This isn't just a matter of best practice; it's a legal obligation. Under New Zealand's Health and Safety at Work Act 2015, all employers have a primary duty of care to ensure the health and safety of their workers. This includes protecting them from exposure to bodily fluids and contaminated materials. Continuing with manual sluicing, when safer alternatives are available, directly conflicts with this fundamental duty to eliminate or minimise risks as far as is reasonably practicable.

Fortunately, the industry has progressed. Modern standards now explicitly recommend moving away from manual sluicing. AS 4146:2024 (Laundry practice) states that fouled items should be processed directly using a washing machine's chemical or thermal disinfection cycle, making manual sluicing unnecessary. This is supported by NZS 8134:2021 Ngā paerewa Health and disability services standard, which requires that laundry be handled safely and hygienically to minimise infection risk.

This shift is made possible by two key advancements:

1. Improved incontinence products: Modern designs are far more absorbent and effective, significantly reducing the amount of soiling that reaches linen and clothing.
2. Commercial laundry machines: These are equipped with validated disinfection cycles that use thermal (heat), chemical, or a combination of both to effectively clean and sanitise even heavily soiled items without the need for pre-rinsing. The key is to ensure these machines are properly serviced and their automatic dosing systems are active to guarantee effective disinfection.

Eliminating sluicing doesn't complicate the laundry process—it makes it more straightforward. The recommended best practice, as outlined in the Waihi Lifecare report, is simple, safe, and efficient.

1. Sort at the Source: Instead of handling soiled linen multiple times, staff should sort it at the point of collection in the resident's room or a designated area. Use a system of clearly marked, colour-coded, and leak-resistant laundry bags to separate different categories of linen.
Heavily fouled items should be placed in their own separate and distinct bags. Bags should be filled to no more than three-quarters capacity to prevent spills and strain.

2. Direct-to-Machine: The sorted bags are then placed in covered trolleys and taken directly to the laundry. From there, the bags are simply emptied directly into the washing machine, and the bag itself is laundered along with the contents. This "no-touch" technique drastically reduces staff exposure and the risk of environmental contamination. Bags containing heavily soiled items can be washed separately on a suitable heavy wash cycle to ensure a thorough clean.

3. Repurpose the Space: With sluicing eliminated, the now-redundant sluice room can be converted into a dedicated decontamination or cleaning zone. By removing unnecessary storage and drying racks, this space can be repurposed to enhance overall facility hygiene rather than undermine it.

Adopting this contemporary approach provides evident benefits for residents, staff, and the entire facility.

• Enhanced Safety: It significantly lowers the risk of infection transmission for both vulnerable residents and frontline staff by minimising exposure to pathogens.
• Enhanced Compliance: It ensures your facility meets the latest industry standards (AS 4146:2024 and NZS 8134:2021) and your legal obligations under the Health and Safety at work Act 2015.
• Greater Efficiency: It establishes a more streamlined, logical workflow, saving staff time and reducing manual labour.

The evidence is clear: manual sluicing is an outdated practice that should be left in the past. By adopting modern technology, updated standards, and smarter workflows, aged care facilities can foster a safer and healthier environment for all, residents included. It’s a simple change that marks a significant step forward in the quality of care. 

For more information about this or another topic, contact our friendly team at support@infectioncontrol.care

Infection Prevention questions can be answered on the HUB from EVE, our multilingual “bot”.

We are on Facebook and LinkedIn. Follow us, like and share. 

Take advantage of our expertise in IPC. See the HUB for policies, resources and courses relating to this very important subject. Ask EVE for a quick answer to your question.