The various medical guidelines on hygiene best practice identify the most frequently touched objects or high-touched surfaces in the patient’s room, for example: bed rails, bed surface, supply carts, over‐bed table, remote controls.
Unfortunately, one of the most frequently touched surfaces in the healthcare environment - the hospital curtains, are often omitted from these lists. That means that hospital curtains are not a part of the patient room daily cleaning routine and become a perfect means of transmitting HAIs.
In The NHS Standard Infection Control Precautions Clinical Governance the hospital curtains are included in the ‘’Control of Environment’’ section and the guidelines state:
‘’The healthcare setting, in particular, contains a diverse population of microorganisms and this must be considered when caring for those who are susceptible to infection.
Although potentially pathogenic microorganisms can be detected in air, water and on surfaces, determining their role in infection can be difficult. It must be considered that contamination of all patient/resident/client environments will occur and must, therefore, be controlled.
The transfer of microorganisms from environmental surfaces to patients/clients is largely considered to be via direct (hand) contact with these surfaces.
As a consequence, hand hygiene is paramount in reducing infection spread via this route as well as the appropriate control of the environment.’’
How often are hospital curtains changed or cleaned?
Although the hospital curtains are one of the most touched surfaces in the patient's room, they tend to be forgotten during the daily cleaning routine.
The already mentioned NHS Standard Infection Control Precautions Clinical Governance states that for parts of the environment, which include hospital curtains, the cleaning should be undertaken when:
- the environment is visibly dirty, e.g. contamination with dust, soilage
- immediately when spillages occur
Since there are no specific recommendations for how often the hospital curtains should be cleaned, procedures may vary significantly from institution to institution.
One experiment conducted to find out how quickly hospital curtains can attract harmful bacteria revealed that 92% fresh curtains showed contamination with potentially pathogenic bacteria within just 1 week.
Reading comments on some popular forums, like these ones from Reddit, under the thread ''How often are the privacy CURTAINS changed in the hospital you work at? They seem FOUL and a potential source for nosocomial infections.''...
''this is also a very concerning topic, and interesting to think about. the clinical i'm working on I've never seen nor heard of the curtains being changed, and never thought twice about it. crazy to think about how much still needs to be done in terms of making the rooms hygienic and safe.''
''One of many examples of how we really aren't protecting anyone with isolation precautions. If we really cared about preventing transmission of these things, we would change out the curtains and swab the employees for MRSA. Gowning and gloving is just for show.
My hospital doesn't change the curtains, even in isolation rooms. If they become visibly soiled, it's like pulling teeth to get them changed. Had a patient vomit on a shower curtain once, took 3 phone calls to get the shower curtain taken down. No clue if it was ever replaced.''
... it becomes obvious that hospital curtains are widely neglected and changed only a few times a year in some places (link).
Why are hospital curtains so neglected?
The article ''Reducing HAIs: Awareness, Cleaning and Replacement of Cubicle CurtainsThe'' on InfectionControlTips.com, describes main reasons for hospital curtains cleaning negligence as follows:
‘’Cubicle curtains are proven to be a major source of infection risk, but cleaning, laundering or disposing of these curtains is often forgotten due to lack of time or understaffing issues (Lybert, 2016).
Laundering cubicle curtains takes time for the removal, washing and reinstallation, which is often done by a dedicated cleaning staff or even sometimes hospital staff. New ideas such as disposable cubicle curtains can help reduce this time problem.
One article states that, “health care workers often say grabbing a wipe and wiping off gurney railings is about all that time allows. With this in mind, using surfaces that can be disposed easily or cleaned effectively is critical,” (Lybert, 2016).
Cubicle curtains are not often viewed as dirty unless seen on the fabric: “Privacy curtains are frequently touched by caregivers and thus can become contaminated, particularly at the edges.
Curtains are not always cleaned until they are visibly soiled,” which poses an additional risk in health care facilities as viruses and bacteria cannot be detected by the naked eye, (Stroupe, 2010).
Even though these facts are well-known, some healthcare facilities are still not maintaining, disinfecting and replacing damaged or disease-spreading items as is necessary.’’
In nutshell, the hardships with cleaning hospital curtains are:
- Hospital curtains are soft surface touch points that can often be overlooked in facility cleaning procedures
- Understaffing and lack of time
- Burdensome process for correct and consistent cleaning - it takes time for the removal, washing and reinstallation of the large bulky hospital curtains
So what is the solution?