By Ronnie Garrett – Housekeeping Solutions Magazine
Research of hospitals indicates that both hard and porous surfaces (such as privacy curtains) in patient rooms are contaminated with pathogens and potentially dangerous bacteria such as MRSA (methicillin-resistant staphylococcus aureus) and VRE (vancomycin-resistant enterococcus).
“The problem with privacy curtains, in regard to killing pathogens, is they can’t be dealt with like other inanimate objects in the room,” says Benjamin Tanner, a microbiologist, immunologist and president of Antimicrobial Test Laboratories, Round Rock, Texas. “When patients are discharged, there is a terminal cleaning procedure for their rooms and this is done with liquid EPA-registered disinfectants approved for hard, nonporous surfaces. I’m not aware of any EPA-registered disinfectants for porous surfaces.”
In lieu of that, what choices exist for hospitals and their housekeeping staffs?
Experts agree that the following are ideal options for disinfecting privacy curtains:
• Increase laundering frequencies. Hospitals currently use laundering to clean privacy curtains, but “by their nature they are a pain to wash and don’t get laundered as often as they should,” Tanner says. “Privacy curtains should be laundered as often as budgets will allow.”
To kill germs that linger on the fabric, experts recommend washing privacy curtains with bleach and hot water. When possible, germ counts should be taken after washing.
• Kill germs by physical means, such as with steam vapor units.
“When you apply steam to any surface, commonsense tells you you’re going to kill germs,” says Allen Rathey, president of the Healthy Facilities Institute, Boise, Idaho. “You’re applying dry steam vapor that is only six percent moisture so it will kill germs without damaging the fabric of privacy curtains. Steam kills whatever is there and doesn’t add contamination to the surface.”
This solution works well for privacy curtains, according to Tanner, because curtains require disinfection more often than they need laundering.
“Steam vapor is a means of disinfecting without changing the curtains. It can also be done while patients are in the room,” he says.
• Disinfect the entire room using technology such as an ultraviolet (UV) light that contains the “C” band, which acts as a natural sanitizer. UV-C light decontamination systems can be rolled into empty hospital rooms and turned on for a period of time to kill germs.
“The UV-C light will effectively decontaminate both hard and porous surfaces throughout the entire room,” says Tanner. “UV-C technology is reliable and doesn’t miss surfaces.”
• Consider using disposable privacy curtains. Disposable curtains can be inexpensive and once initially installed, they can be changed easily (in as little as 10 seconds).
“In less than a minute you can change an entire room’s privacy curtains,” says Darrel Hicks, director of environmental services at St. Luke’s Hospital in Chesterfield, Mo., and author of “Infection Prevention for Dummies.” “With traditional curtains, it usually takes a man on a ladder an hour to change them.”
• There are also new chemical means of disinfecting privacy curtains that have emerged. Used in patient rooms, this technology works similar to foggers used to kill insects. The chemical mist sprayed into the air penetrates mattresses, pillows, bedspreads, privacy curtains, carpets, tile and bath surfaces, electronics, furniture and remotes, and protects against pathogenic bacteria for up to 30 days.
Experts agree that chemical-based solutions can be effective, but warn that there are disadvantages to the technology. This technique can be more time consuming than other alternatives mentioned and the chemicals can be harmful to sensitive populations. Studies have shown disinfectant-type chemicals can cause allergies and asthma, says Tanner.
“You need to have an approach that will encourage compliance,” says Tanner. “I think the reason people aren’t disinfecting privacy curtains now is because it takes a lot of work.”
With work comes time and how often the above mentioned disinfecting solutions should be conducted will depend on the facility. That said, experts recommend taking a risk-based approach and finding cleaning or disinfection intervals that lower pathogen levels enough to reduce the risk of hospital-acquired infections (HAIs).
“The greatest deposition of germs on privacy curtains comes from hands when people move the curtains,” Tanner says. “The second greatest would be aerosol deposition when someone coughs or sneezes.”
Hicks agrees and sites situations when germicidal testing revealed MRSA on curtains in rooms where there was no MRSA patient assigned. It was soon determined that he germs were transferred from room to room on healthcare workers hands.
He suggests that privacy curtain contaminants would be reduced if hospital personnel, cleaning staff, patients and visitors practiced better hand hygiene. Cross-contamination also can be reduced if housekeeping staffs properly use disinfectant when cleaning — use proper quantities to achieve a kill claim, adhere to proper dwell times, etc.
“That is not always being done,” Tanner adds. “Everyone says they use this or that disinfectant, but if the dwell time is 10 minutes and your housekeeper is done with the entire room in 10 minutes, disinfection has not occurred.”
Housekeeping staffs also should pay close attention to disinfecting high-touch surfaces — such as bed rails, light switches, supply cart and over bed tables — where cross-contamination from one surface to another might occur. Controlling the contaminants on these surfaces will reduce contamination transfer back to the curtain.
“A recent study of East Coast hospitals over a year showed that half of the high-touch surfaces in the hospitals weren’t cleaned once over an entire year,” Tanner says. He advocates staff education that covers high-touch surfaces, including privacy curtains, and setting protocols for how they should be cleaned.
Forming a committee comprised of healthcare workers, infection control professionals, housekeeping staff and others will help hospitals devise a workable solution and standard for privacy curtains.
“You have to work together on this,” Hicks says. “It’s going to take a house-wide campaign to limit cross-contamination, and to come up with a privacy curtain solution that doesn’t break the bank.”
Click here to read about the negative affect these curtains have on health.
Ronnie Garrett is a freelancer based in Fort Atkinson, Wis., and is a frequent contributor to Housekeeping Solutions.