Cubicle curtains the elephant in the room
Each year, health care-associated infections cost health systems millions. The main culprit of transmission is improper hand hygiene prior to touching various surfaces in a patient room.
The Centers for Disease Control and Prevention (CDC) identified 23 high-touch objects in patient rooms. However, cubicle curtains did not make the list even though they rank as the sixth most commonly touched surface. In fact, one study in the November 2008 issue of Infection Control & Hospital Epidemiology has indicated that 42 percent of privacy curtains are contaminated with vancomycin-resistant enterococci, 22 percent with methicillin-resistant Staphylococcus aureus and 4 percent Clostridium difficile — making them the elephant in the patient room.
Essentially, patient cubicle curtains serve two purposes: privacy and safety. Caregivers can use curtains as a screen while delivering procedures. They also take on the splash of blood and other potential infectious materials in acute care areas.
While cubicle curtains serve important purposes, how to clean and how often to change them is a conundrum. There are several issues involved:
• Many organizations have not developed a cubicle curtain cleaning or changing policy.
• Many organizations do not document cubicle curtain changes.
• The hospital does not have room to store a sufficient inventory.
• Laundering slows room turnaround time.
• Hanging curtains often requires added resources like ladders and extends the room turnaround time.
It’s time to rethink cubicle curtains and consider non-fabric solutions that could include:
• Determining which department “owns” the cubicle curtains.
• Using standard sizes with varying mesh lengths and hardware that allow housekeepers to remove curtains without using ladders.
• Using polypropylene recyclable curtains that eliminate laundering and cost a tenth of what fabric curtains cost. They can be stacked in totes so the curtains become part of the hospital’s supply chain.
• Considering using glass privacy panels.
• Using curtains that have a clean edge or pull handle that helps users to know where to place hands.
• Documenting changes to ensure that curtains are cleaned regularly.
Whatever the solution, it’s essential that departmental colleagues — facility designers, nursing, environmental services, infection prevention and others — collaborate to find best-practice solutions.
Mitch Birchfield is owner of Birchfield Environmental Analytics and has served as an interim hospital support service manager, director and consultant at health facilitites across the country.
Practice guidance available
Practice Guidance for Healthcare Environmental Cleaning, second edition, helps to define and advance the professionals responsible for care of the health care environment to ensure high-quality outcomes and healthy communities. This manual provides evidence-based research, guidance and recommended practices that should be considered for inclusion in health care environmental services departments. Because each facility has its own needs, this resource has been designed to enhance an existing program. For more information, visit www.ahe.org/ahe/learn/tools_and_resources/publications.shtml.
Certified Healthcare Environmental Services Technician Certificate
This certification focuses on critical areas of competency for front-line technicians, including infection prevention, quality of care, patient outcomes and experience. For more information, visit www.ahe.org/ahe/lead/CHEST/chest_home.shtml.
Environmental Sustainability Certificate Program
AHE has launched a certification to acknowledge the environmental and ecological sustainability efforts of environmental services departments. For more information, go to www.ahe.org/ahe/lead/environmental_sustainability_ certificate_program.shtml.