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 cross-transmission of pathogens, including “super bug” organisms. Ideally, each patient admitted to a freshly cleaned and disinfected bed/room should have a fresh curtain to ensure both safety and privacy.
A comprehensive Management Program for privacy curtain exchanges should consider the following questions:
- During outbreaks, should we exchange curtains bi-weekly in patient care areas that are of concern?
- Are we immediately changing curtains upon the discharge or transfer of patients on Contact Isolation, how are we documenting the exchanges and are we able to analyze such data?
- How do we ensure that privacy curtains are free of spots and stains and immediately exchanged when they become “visibly soiled”?
- Do we have a program in place that ensures curtains with stains larger than a quarter that cannot be removed with treatment and laundering will not be returned to service, how are they discarded and replaced?
Any privacy curtain exchanged for the reasons above 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 the patient, their uniform, or to other surfaces. Managers should document such training and perform periodic competency assessments whether staff are in compliance with the established policies.
Employees should wear personal protective equipment protecting them from contact with the curtain (e.g., isolation gown, protective eyewear, gloves and mask). Upon removal curtains should be bagged while in the room and if a ladder is necessary to exchange the curtains, the ladder must be disinfected prior to removing it from the patient’s room. EVS should always maintain accurate records of each curtain change documenting that your facility’s curtain change policy is current and being adhered to.
Facilities should always focus cleaning resources on high risk/high touch surfaces as frequently touched surfaces have been proven to harbor and transmit microbial pathogens.
Note that when using UV-C Light to please not forget the privacy curtain! What good does it do to have a clean room yet the curtain that was left hanging in place is still dirty and contaminated…
Things to consider when tying your curtain protocol exchange to UV-C disinfection:
- UV-C is not for daily use and tends to be used during terminal cleans: room must be clear of occupants.
- It cannot replace a facilities’ protocol on laundering as the technology does not remove dust nor stains.
- Delays turn-over time in a room vacated by a patient with C-diff as it takes up to 50 minutes to eliminate all spores.
- In order to treat a curtain, it must be pulled open. E.g. UV-C equipment needs to be relocated to ensure both sides of the curtain are treated to reach efficacy.
- Various studies express concern as to whether UV-C is effective in disinfecting curtains.
- UV-C deployment should trigger a work order to exchange all curtains in a patient room
Based on this, many facilities are weighing the cost differences between reusable and recyclable curtains, wondering which product might be more effective in mitigating HAIs and creating a safe environment for their patients and staff.
It is very important to always compare overall cost differences between the two options, ensuring that you are including all reusable curtain costs such as laundering and replacement costs rather than just acquisition cost. This especially as 10% of all laundered curtains statistically get lost or damaged/ragged out during the process.
A 500-bed facility with an bi-annual exchange protocol and a 10% daily Isolation room rate on average will:
- Exchange up to 5,700 curtains each year
- Spend approximately $117k on purchasing replacement curtains
- Incur laundering costs ranging from $46k to $68k ($8-$12 per curtain panel)
Ultimately, a comprehensive cost saving curtain management protocol that allows for automated reminders while gathering meaningful metrics on historical exchanges will empower management to make informed decisions about curtain types deployed as well as setting more relevant curtain exchange frequencies.
