Hospital Laundry Research Articles

In situ performance evaluation of a solar water heating system for a hospital laundry in the Sahel

There is a limited number of empirical studies on the actual energy output of solar water heating systems (SWHSs). In the Sahel, where solar potential is abundant, the transition to sustainable energy solutions requires comprehensive evaluations of SWHSs, including their economic viability. Such assessments are crucial for informed decision-making by stakeholders and for facilitating the widespread adoption of SWHSs, including their integration into industrial processes. This paper presents a year-round experimental study assessing the real-world performance and economic viability of a SWHS integrated into a hospital laundry in Ouagadougou, Burkina Faso. The primary aim of the study is to analyse the practical performance of the integrated collector storage (ICS) SWHS and evaluate its economic viability. The performance of the ICS SWHS is monitored over the course of a year. Data collection included measurements of solar irradiation, ambient temperature, inlet and outlet water temperatures, and energy output of the SWHS. Economic assessments considered factors such as installation costs, energy savings, and payback periods. Environmental implications were evaluated through the estimation of avoided CO2 emissions. The ICS SWHS achieved an efficiency of 38 % and a solar fraction of 17 %, resulting in approximately 1.3 t of avoided CO2 emissions annually. Economic assessments revealed extended payback periods, leading to exploration of alternatives. Subsequently, a water-in-glass evacuated tube collector (ETC) system, deemed more cost-effective, was selected and it indicated superior energy production. Preliminary results suggest compelling payback periods for the ETC system, ranging from 3.1 to 4.5 years under realistic scenarios. The study underscores the significance of practical experimentation, appropriate technology selection, and improved market regulations for informed decision-making. SWHSs present a promising avenue for sustainable energy solutions in the Sahelian region and beyond, offering both economic benefits and environmental impact.

Carbon footprint of hospital laundry: a life-cycle assessment

ObjectivesTo assess greenhouse gas (GHG) emissions from a regional hospital laundry unit, and model ways in which these can be reduced.DesignA cradle to grave process-based attributional life-cycle assessment.SettingA large hospital...

USO DE COAGULANTES NO TRATAMENTO DE EFLUENTE DE LAVANDERIA HOSPITALAR: A BUSCA POR PROCESSOS FÍSICO-QUÍMICOS SUSTENTÁVEIS VISANDO REMOÇÃO DE POLUENTES E MICRORGANISMOS PATOGÊNICOS

USE OF COAGULANTS IN THE TREATMENT OF HOSPITAL LAUNDRY EFFLUENT: THE SEARCH FOR SUSTAINABLE PHYSICAL-CHEMICAL PROCESSES TO REMOVAL POLLUTANTS AND PATHOGENIC MICROORGANISMS. Hospital laundry is an important source of environmental pollution because its effluent contains high loads of organic matter and microorganisms. Conventionally, the treatment is carried out using aluminum sulfate, a low-cost and highly efficient coagulant that is related to secondary contamination due to the generation of non-biodegradable sludge, its ability to accumulate metals and toxicity. Aiming for sustainable alternatives, the efficiency of tannin from the natural coagulant and Moringa oleifera seed was evaluated in relation to aluminum sulfate, seeking to adapt the color and turbidity parameters and determine the antimicrobial activity of the seed. Using a concentration of 100 mg L-1 of aluminum sulfate, 97.4 and 93.95% of color and turbidity removals in the effluent were obtained, respectively. With 50 mg L-1 tannin showed an efficiency of 84.96% for color removal and 89.75% for turbidity. Tests were also carried out with Moringa oleifera seeds using saline seed extract, crushed seeds and aqueous seed extract, with a reduction in conductivity by more than 99%, removing pollutant ions for the saline extract. Of the methodologies used, the best result was obtained with the aqueous extract, achieving removals of 89.63% of color, 78.33% of turbidity, and inhibition of more than 98.1% of microorganism growth.

Isolation of pathogens from Hospital laundry water

Isolation of pathogens from Hospital laundry water

Physician Attitude toward Their Attires and Laundering Habit Changes during the COVID-19: A Cross-Sectional Survey in a Tertiary Care Center.

Background Patient safety is of utmost importance and every effort is to be made to reduce the risk of hospital-acquired infection. Contaminated attire is proposed as a mode of hospital infections spread. This study aims to assess the laundering habits, the perception of healthcare workers toward the contamination of their attire, and the effect of coronavirus disease 2019 (COVID-19) pandemic on their cleaning practices in non-operative settings. Methods This is a cross-sectional study conducted using a self-administered questionnaire which was distributed among physicians at King Abdul-Aziz Medical city, Riyadh. The questionnaire queried the physicians about their laundering habits, knowledge toward their attire, and the difference in cleaning practices after the emergence of COVID-19. Results Out of 220 questionnaires distributed, 192 physicians responded. Majority of physicians were male (54%) and were in the 20 to 30 age group. Female gender was significantly associated with the frequency of uniform washing ( p- value < 0.0001) and place of cleaning (home vs. outside home) ( p- value <0.0001). Physicians in intensive care were more likely to take off their uniforms daily before leaving the hospital compared to others ( p- value of 0.018). Most physicians did not prefer to use the hospital laundry system for cleaning their uniforms but consultants were the most to use it. COVID-19 pandemic led to changes in washing habits in 108 physicians (60%). Conclusion Majority of physicians accepted washing their uniforms multiple times per week and their washing habits increased during the COVID-19 pandemic. Female gender and younger physician both were associated with increasing washing habits.

Occupational Health Hazards among Workers in Hospital Laundry Department at Benha City

Background: Workers in hospital laundry have exhausting duties and are exposed to various environmental and work related problems. The aim of the study: was to assess the occupational health hazards among workers in Hospital Laundry Department at Benha City. Research design: A descriptive research design was utilized to conduct this study. Setting: The study was conducted at the laundry departments of Governmental and Non-Governmental Hospitals at Benha City. Sampling: A Convenience sample of all Hospital Laundry Workers 110 divided into 55 in Governmental Hospitals and 55 in Non-Governmental Hospitals was involved in this study. Tools: Two tools were used. Tool I: A structured interviewing questionnaire it consist of four items: A: socio-demographic characteristics of the studied laundry workers. B: Job characteristics of the studied laundry workers. C: It was concerned with health problems among studied laundry workers. D: It was concerned with studied laundry workers knowledge about occupational health hazards and safety measures. Tool II: Observational checklist which consisted of two parts A: assess laundry workers practices regarding safety measures. B: Assess the workplace environment safety and sanitation condition. Results: 34.5%of the studied laundry workers in Non-Governmental Hospitals had poor knowledge about occupational health hazards. 69.1 % of the studied laundry workers in Non-Governmental Hospitals had satisfactory regarding their total practices. Conclusion: the current study revealed that the majority of the studied laundry workers had health problems. Recommendation: perform health education program for laundry workers about occupational health hazards and preventive measures.

MLST typing of Acinetobacter baumannii in a hospital outbreak

Background and objective: Carbapenem-resistant Acinetobacter baumannii (CRA) is a WHO-designated priority antibiotic-resistant pathogen. In this study, we performed Multi-Locus Sequence Typing (MLST) for the clinical and environmental CRA isolates recovered from an investigation of a hospital CRA outbreak. Methods: CRA was recovered from 58 patients and multiple environmental sites. Twenty-four clinical and 11 environmental isolates were selected for MLST. MALDI-TOF and OXA-51 gene PCR were used for identification of Acinetobacter baumannii. MLST was done by Sanger sequencing. Fisher’s exact test was used for analysis of categorical variables. Results: Extensive patient screening and environmental sampling identified the hospital laundry as the likely source of CRA outbreak across multiple wards. CRA isolates of ST345 from hospital laundry cooler machine was identical to that of 11 patients across different wards. CRA isolates of ST1145 from three laundry linen racks were identical to that of seven patients across different wards. CRA isolates of ST2207 found in another linen rack were identical to that in three other patients across different wards. Antimicrobial susceptibility patterns of CRA isolates could not accurately differentiate between different ST. Conclusion: MLST result demonstrated the link between contamination of laundry cooler and environment and the hospital polyclonal CRA outbreak.

Removal of polyester fibre microplastics from wastewater using a UV/H2O2 oxidation process

Plastic microfibres originating from laundry wastewater are released in significant numbers to the environment due to a current lack of suitable removal technology. Advanced oxidation processes could offer a promising option to mitigate the problem due to their ability to destruct organic pollutants rather than transferring them to other forms. In this study, the effect of UV irradiation and hydrogen peroxide treatment on the removal of microplastics (MPs) was determined. MPs mass loss, carbonyl index (CI) change, and physical changes on their surface, as characterised by Fourier transform infra-red spectroscopy, scanning electron microscopy and atomic force microscopy were monitored. Additionally, the chemical oxygen demand (COD) of the water was monitored to examine the release and degradation of soluble organic material from MPs. The effect of varied UVC dose and H2O2 concentration was investigated. A dose of 500 mg L-1 H2O2 under 4.0 mW cm-2 UVC irradiation resulted in mass loss of 52.7% after 48 h (with a calculated half life of 45.3 h). Also, it was observed that degradation of fibres occurred through the formation of shallow holes, pits and cracks across their surface as well as changes in the relative abundance of oxygen containing functional groups. This chemical change was evidenced by the CI of treated MPs, which was increased up to 10.6% compared to untreated fibres. Moreover, the proposed UVC/H2O2 treatment could degrade 15.2% MPs and completely remove COD in real hospital laundry wastewater matrix within 9 h and 3 h of treatment, respectively.

Design of a hospital laundry effluent clarification system

Approximately 20% of the mineral coal ash (MCA) generated worldwide, during the combustion of this fossil fuel, has been used to produce Portland cement. Other applications include soil improvement, ceramic industry, catalysis, and an application with special interest for this work which is the synthesis of zeolites. A hospital effluent clarification system was developed using MCA as an adsorbent for substances responsible for the color of the effluent generated by the laundry. A perfect mix tank promotes intimate contact between MCA and the effluent. At the exit of the mixing tank, a pH sensor correlated the value of this variable with the concentration of MCA in the mixture inside the tank. The information about the pH of the mixture was then sent to a programmable logical controller (PLC), which regulated the motor speed of a screw conveyor, with the aid of a frequency inverter. A color removal efficiency of the order of 99.8% was achieved. The proposed clarification system can operate both in batch and continuous. In the first case, the ideal operating conditions can be set. The strategy for adjusting operating conditions is to obtain an adequate nominal capacity for the system by reducing or increasing the number of cyclones per battery or the number of cyclone batteries.

Clean clothes or dirty clothes? Outbreak investigation of carbapenem-resistant Acinetobacter baumannii related to laundry contamination through multilocus sequence typing (MLST).

To investigate the source in an outbreak of carbapenem-resistant Acinetobacter baumannii (CRA) in a general hospital due to contamination of a laundry evaporative cooler and the laundry environment using multilocus sequence typing (MLST). For CRA culture, clinical samples were collected from infected patients and close contacts, and environmental sampling was performed in patient surroundings and laundry facilities. MLST was used for the molecular typing of representative CRA isolates. Bacterial isolates with identical sequence types were considered epidemiologically linked and attributable to the same source. OXA genes in Acinetobacter baumannii were detected using polymerase chain reaction (PCR). In total, 58 patients were affected in this outbreak. The mean patient age was 75.3, and 50% were female. The most common diagnoses at admission were skin and soft-tissue infection (n = 12, 20.7%) and pneumonia (n = 12, 20.7%). OXA-23 was positive in 64.7% of isolates. A CRA isolate from the evaporative cooler in the laundry was identical to that of 11 patients across 3 wards, belonging to ST345. Isolates from 3 laundry linen racks were identical to those of 7 patients from 3 wards, classified as ST1145. Isolates found on another linen rack and a pajama shelf were identical to isolates from 3 other patients from 2 wards, belonging to ST2207. There was no significant difference between sequence type distributions of clinical and environmental isolates (P = .12), indicating high likelihood of CRA originating from the same source. MLST confirmed that contamination of the laundry evaporative cooler and surrounding environment caused a polyclonal CRA hospital outbreak. Hospital laundry is an important area for infection control and outbreak investigations of CRA.

Predictive models in the ultrasonic disinfection of hospital-effluents: a review and suggestion for future research

At the end of this review on applications of ultrasonic waves in the inactivation of microorganisms in hospital laundry effluents, the fourth type of predictive model is proposed, based on the application characteristics of the experimental plans. The number of works for the disinfection of wastewater by ultrasound waves (US) associated with other techniques or individuals has been increasing. The use of ultrasound to produce lethal effects on microorganisms is attractive because it is considered a "green" technology in that it involves sound energy and does not require additional chemicals, or a very small amount. Also, the US as a tool for water reuse processes - operates at low pressure and temperature and does not produce toxic or greenhouse gases. Hospital laundry effluents are characterized by different microorganisms, a fact that can hinder the application of conventional physical-chemical technologies. To contribute to future developments in the application of ultrasound (US), this work uses some typical US applications in the disinfection of aqueous effluents. To propose strategies for carrying out new works, comments are made regarding an approach oriented towards new advances based on the need to interrelate the variables involved in the studies, at the same time that these variables are correlated with the rate of inactivation. For this, it is discussed the predictive models and their contributions, according to the number of factors that should be involved for a better understanding of the rate of microbial inactivation.

Comparison between effects of manothermosonication and isolated ultrasonic techniques on microbial inactivation of a hospital laundry effluent

Microbial inactivation using only Ultrasound (US) vibrations presents considerable advantages by applying green techniques with non-generation of greenhouse gases, eliminating chemicals, and operating conditions close to environmental conditions. However, industrial effluent treatment systems have been investigated as a microbial inactivation step, using isolated US associated with thermal (T) and manometric (P) microbial inactivation techniques. A stainless-steel bench prototype was built for the present study, operating in continuous mode, with a 2.5 L volume test chamber. The indicator microorganism detected in the effluent of a hospital laundry located in the Agreste region of the state of Pernambuco, Brazil, was the E. coli bacterium. In addition to the isolated US effect, US/T, US/P, and US/T/P combinations were obtained using a central composite design (CCD). The factors used for the CCD were frequency, hydraulic detention time, temperature, and pressure. The results showed that the lethality rate increased with the frequency and time of hydraulic detention but was reduced when increasing temperature from 30°C to 50°C and increasing pressure between 1.0 bar and 1.8 bar. Isolated ultrasonic vibrations, at 120 kHz and with 10-minute HRT, reached an inactivation efficiency of 98%. Such a value was found using the thermomannosonic condition around 40 min. The use of the isolated US vibration technique proved advantageous, mainly due to the efficient inactivation results and potential energy and chemical reductions.

Microbial fuel cells and constructed wetlands as a sustainable alternative for the treatment of hospital laundry wastewaters: Assessment of load parameters and genotoxicity

This research investigated the sequential use of microbial fuel cells (MFC) and constructed wetlands (CW) for the treatment of wastewaters generated at a hospital laundry. The MFC was vegetated with Chrysopogon zizanioides whereas Hymenachne grumosa was planted in the CW unit. The hydraulic retention time in each unit was of 7 days, totaling 14 days of treatment. The evaluation of the efficiency of the integrated system considered the analysis of load parameters and the genotoxicity potential before and after the treatments. Regarding the raw wastewaters, the results revealed mean values of some of the analyzed parameters above the maximum emission limits established by Brazilian and international guidelines. Furthermore, the untreated effluents presented a strong genotoxic effect (p < 000.1) against D. magna. On the other hand, the results of the treated wastewaters showed reductions of 79.8 %,78.6 %, 81.6 %, 53.1 %, 81.5 % and 99.9 % for COD, BOD5, Total N, TDC, DOC and Turbidity. Also, the treated wastewaters presented significant reductions (p < 0.05) of the genotoxicity. Therefore, the use of the integrated system showed that both units had complimentary effect and presented satisfactory results regarding the removal of the organic load, complying with national and international standards and significantly reduced the genotoxicity. The maximum open circuit voltages reached values of 148 mV using the graphite electrodes, whereas for the granular activated carbon electrode the bioenergy generated attained 268 mV. So, besides been effective, the integrated system can be sustainable from both environmental and economic aspects, especially for developing countries, where there is limited or insufficient wastewater treatment infrastructure.

Bacterial counts of hospital linen and effectiveness of laundry process

Background: Health care linen is a source of healthcare-associated infections. Hospital laundry services play a vital role in linen decontamination. Effective laundry is essential in preventing hospital-acquired infections, especially in multidrug-resistant organisms. Aims and Objectives: The study aimed to check the microbial load in linen after the laundry process and the during the supply chain in the hospital. We investigated the bacterial load in linen before and after the laundering process and the linen from stored linen banks. Materials and Methods: Linens (n=125) from the hospital were collected in different stages of the laundry process [31 linen before decontamination; 94 linen after decontamination (Post washing = 30; Linen Bank = 34; Ward 30)]. A square inch of linen from each linen was vortexed in normal saline, and colony forming units (CFU)/inch of linen were calculated using appropriate media. The identification and susceptibility of organisms were performed using MALDI-TOF MS and CLSI disk diffusion methods, respectively. The difference in the load of the organism was analysed between different stages of the laundry and storage process. Results: We found that100% of pre-decontamination linen harbour viable organisms (22.59% including multidrug-resistant pathogenic organisms: MDROs), which decreased to 40% (no MDROs) post-decontamination. The overall load was reduced by a factor of 103.77. Conclusion: The microbial contamination of linen is common, and there is an urgent need to develop consensus on the microbial examination frequency and acceptable range of organisms on hospital linen worldwide.

Reusable textile microfiber and laundry in healthcare: Critical analysis of problematic published information

Recent analyses of environmental services products and practices in healthcare have covered the concepts of hygienically clean, mechanisms of cleaning, and comparison of reusable and disposable textile microfiber products. In 11 referred papers, it was discovered that three had sufficient factual errors to influence the citations found in the broader literature. This study evaluating these problematic papers is an obligation of the scientific community for accuracy. In light of newer data on the efficacy of important textiles for microfiber cleaning, these previous studies were reexamined to see if methodological corrections are needed. Closer investigation of the authors’ data was used to ascertain the validity of their initial conclusions. These current reevaluations reverse conclusions in these journal articles. It appears factors such as multi-variant statistical comparisons, combining variables, and use of extremely high inoculum for cleaning led to the wrong conclusions in these three papers. The revised results show that for hospital surface cleaning with reusable textile microfiber products, no detectable levels were found for two of the most challenging organisms for hospital-acquired infections, methicillin-resistant Staphylococcus aureus and Clostridium difficile. Commercial laundry was substantially better than hospital laundry and reusable microfiber products improved with use.

Physicochemical assessment of urban wastewater of Cotonou (Benin).

The present study aims to fill the data gap analysis in urban wastewaters characteristics in Benin and its statistical analysis. Physicochemical parameters such as pH, electrical conductivity (EC), Chemical Oxygen Demand (COD), Biochemical Oxygen Demand (BOD5), Total Kjeldahl Nitrogen (TKN), Total Phosphorus (TP) and UV Absorbance at 254 nm, were determined on domestic (greywater and blackwater) and industrial (hospital, pharmaceutical and commercial laundry) wastewater in Cotonou city. Analysis of variance showed a strong significant difference in the physico-chemistry of the various effluents. The pharmaceutical wastewater has the highest concentration of organic pollution (COD = 5,912 ± 1,026 mg/L, Abs.UV254 = 2.667 ± 0.327 cm-1). The organic load of blackwater is mainly in particulate and biodegradable form. Besides, the correlation study showed the limits of pH and EC as an indicator of organic load. Furthermore, the choice of COD or BOD5 as the main design parameter would be limited to blackwater treatment. Abs.UV254 was found to be the parameter having a strong relationship with other parameters of all effluents except blackwater. It then takes priority over COD for the treatment of greywater and industrial wastewater. For future wastewater treatment plant design, we recommend to consider Abs.UV254 as an important parameter.

Quality control study of hospital laundry in a tertiary care hospital

Introduction-Hospital laundry are potential reservoirs of bacteria in hospitals. Preventing contamination and providing clean linen and laundry should help to prevent hospital acquired infections. Being an important component in the management of patients and the role in causing hospital acquired infections, the study about hospital laundry has been undertaken in our hospital. Methods- Quality control practiced in the Linen and Laundry Service was studied by conducting a prospective study. Samples were taken from the surface of these materials by sweep plate method prior to washing procedure. The second set of samples were collected from the same materials after the washing procedure. The organisms were identified by colony morphology, culture characteristics & biochemical reactions according to standard techniques. Results- Out of the 30 samples studied, 24 (80%) of them were contaminated with bacteria before washing. Organisms yielded were Staphylococcus aureus, coagulase negative Staphylococcus (CONS), Aerobic spore bearing bacilli (ASB), Escherichia coli and Pseudomonas aeruginosa. After washing, 25 (83%) of the clothes were sterile. Conclusion- Though terminal cleaning fails to completely eliminate bacteria from the laundered fabrics, it is effective in considerable reduction in bacterial growth.

A Qualitative Study of Barriers to Personal Protective Equipment Use among Laundry Workers in Government Hospitals, Hawassa, Ethiopia.

Background The need to reduce the transmission of infectious diseases makes the use of personal protective equipment and safety medical devices compulsory among hospital laundry staff. The practice, however, remains to be low among hospital laundry staff members. Globally, not many studies seem to have been carried out to sufficiently tell us about the barriers to personal protective equipment use among hospital laundry workers. Related studies in Ethiopia are even fewer. This study assessed the barriers to personal protective equipment use among laundry staff of government hospitals in Hawassa City, Southern Ethiopia, 2019. Methods Two qualitative data-gathering methods—focus group discussions and key informant interviews—were used to collect data for this study. Eight focus group discussions were conducted with hospital laundry workers. Similarly, six key informant interviews were held with Infection Prevention and Patient Safety Officers. Thematic analysis was performed using Open Code 4.02. Result Organizational- and individual-level barriers such as unavailability of essential personal protective equipment, a disharmonious work environment, low perception of susceptibility, and belief about personal protective equipment interference with work performance were identified as the major barriers to personal protective equipment use in the present study. Conclusion Organizational- and individual-level barriers have been identified as causes for the low level of personal protective equipment use among hospital laundry workers. Therefore, improving institutional supplies in quantity and quality may have a positive implication for the improvement of infection prevention practices in the study area. Also, designing sustainable strategies and raising laundry workers' awareness of a safe work environment may lead to the improvement of infection prevention practices.

Contamination and washing of cloth masks and risk of infection among hospital health workers in Vietnam: a post hoc analysis of a randomised controlled trial.

BackgroundIn a previous randomised controlled trial (RCT) in hospital healthcare workers (HCWs), cloth masks resulted in a higher risk of respiratory infections compared with medical masks. This was the only published RCT of cloth masks at the time of the COVID-19 pandemic.ObjectiveTo do a post hoc analysis of unpublished data on mask washing and mask contamination from the original RCT to further understand poor performance of the two-layered cotton cloth mask used by HCWs in that RCT.Setting14 secondary-level/tertiary-level hospitals in Hanoi, Vietnam.ParticipantsA subgroup of 607 HCWs aged ≥18 years working full time in selected high-risk wards, who used a two-layered cloth mask and were part of a randomised controlled clinical trial comparing medical masks and cloth masks.InterventionWashing method for cloth masks (self-washing or hospital laundry). A substudy of contamination of a sample of 15 cloth and medical masks was also conducted.Outcome measureInfection rate over 4 weeks of follow up and viral contamination of masks tested by multiplex PCR.ResultsViral contamination with rhinovirus was identified on both used medical and cloth masks. Most HCW (77% of daily washing) self-washed their masks by hand. The risk of infection was more than double among HCW self-washing their masks compared with the hospital laundry (HR 2.04 (95% CI 1.03 to 4.00); p=0.04). There was no significant difference in infection between HCW who wore cloth masks washed in the hospital laundry compared with medical masks (p=0.5).ConclusionsUsing self-reported method of washing, we showed double the risk of infection with seasonal respiratory viruses if masks were self-washed by hand by HCWs. The majority of HCWs in the study reported hand-washing their mask themselves. This could explain the poor performance of two layered cloth masks, if the self-washing was inadequate. Cloth masks washed in the hospital laundry were as protective as medical masks. Both cloth and medical masks were contaminated, but only cloth masks were reused in the study, reiterating the importance of daily washing of reusable cloth masks using proper method. A well-washed cloth mask can be as protective as a medical mask.Trial resgistration numberACTRN12610000887077.

AVALIAÇÃO DE MUDANÇAS NO MODELO DE PRESTAÇÃO DO SERVIÇO DE LAVANDERIA HOSPITALAR: O CASO DO HOSPITAL DE CLÍNICAS DA UNIVERSIDADE FEDERAL DE UBERLÂNDIA

O objetivo desta pesquisa foi avaliar os diferentes modelos de contratação do serviço de lavanderia hospitalar do HC da Universidade Federal de Uberlândia quanto ao controle dos custos e melhoria no atendimento dos pacientes e profissionais do hospital e à disponibilidade de enxoval hospitalar em condições adequadas de uso. Com abordagem qualitativa e uso de estudo de caso único, a coleta de dados foi feita por meio de pesquisa documental em contratos, memorandos, ofícios e termos de referência. No período de 2010 a 2018, houve três diferentes modalidades de contrato do serviço de processamento de roupas com melhorias e ajustes, em um processo constante de aprendizagem de seus gestores. Como contribuição, foi sugerido um novo modelo como forma de superar os entraves e problemas dos três contratos anteriores e melhoria da prestação do serviço, com possibilidade de redução de custos, facilidade de gestão e adequação da forma de terceirização.