In “Fear the Curtain” Parts 1 and 2, I attempted to define the current state of affairs as it relates to privacy curtains in hospitals. First, healthcare workers and patients frequently touch privacy curtains before, during and after care encounters. This may promote transfer of bacteria to curtains. Indeed, studies have found that curtains are frequently contaminated with potentially pathogenic bacteria, including VRE and MRSA.
Second, available evidence suggests that bacterial pathogens on privacy curtains may travel to patients by way of healthcare workers’ hands. Healthcare workers are likely to touch curtains after performing hand hygiene but before patient care.
Third, privacy curtains are difficult to disinfect and clean and are infrequently changed. In many institutions, curtains may hang for several weeks or months before changing. Because pathogens may survive on hospital surfaces for days or weeks, this makes privacy curtains potentially important vehicles for transmission of pathogens from prior room occupants to new patients.
Therefore, I would like to propose a complete standard for changing privacy curtains. Here for your review and comment, is the policy.
A Complete Standard for Changing Privacy Curtains
In order to provide a safe and clean environment in the “patient zone” (the patient’s bed, bed rails and everything within 36” of the bed), privacy curtains must be managed so they do not contribute to the cross-transmission of pathogens, including “super bug” organisms.
A Management Program for privacy curtains should include the following elements:
1) During outbreaks, change curtains twice weekly in patient care areas of concern.
2) Upon discharge or transfer of patients on Contact Isolation, change curtains.
3) Privacy curtains must be aesthetically free of spots and stains. Change curtains when they become visibly soiled. If stains larger than a quarter ($.25) cannot be removed with treatment and laundering, they should not be returned to service; they must be discarded and replaced.
4) Each patient who is admitted to a freshly cleaned and disinfected bed/room should have a fresh curtain for their privacy.
5) All privacy curtains being changed for reasons 1-4 should be considered contaminated by those who are responsible for removing them. Employees should be thoroughly trained on disease transmission and preventing cross-transmission of disease from the curtain to their uniform or other surfaces. Document that training and perform a competency assessment. Employees should wear personal protective equipment that will protect them from contact with the curtain (i.e., isolation gown, protective eye-wear, gloves and possibly a mask). Curtains should be bagged in the room and the bag tied shut. If a ladder is necessary to remove the curtains, the ladder must be disinfected before removing it from the patient’s room.
6) Keep an accurate record of each curtain change documenting that your facility’s curtain change policy is being followed.
Questions or comments are welcome.