Reducing HAIs: Awareness, Cleaning and Replacement of Cubicle Curtains

Abstract

Healthcare-Associated Infections (HAIs) are caused by a variety of pathogens which can often thrive on soft surfaces and are easily spread. This poses a danger for everyone who works in, receives treatment from or visits a healthcare facility. Many of these hospital infections are ultimately harmless. However, there are certain infections that pose a greater risk to healthcare staff, visitors and patients, especially those with compromised immune systems. These particularly dangerous HAIs can result in death for an infected person and ruin a facility’s reputation. The current cleaning measures in place must be improved in order to keep patients, visitors and staff safe. Proper infection control procedures, such as laundering and replacement of cubicle curtains in healthcare facilities can help to reduce the risks and the spread of HAIs.

Introduction

When one thinks of hospitals or healthcare facilities, a crucial item should always come to mind ─ cleanliness. The cleaning of a healthcare facility is important to patients and visitors. Some patients are required to stay at long-term care facilities, so it is important for patients and visitors to know that they are safe from bacteria and viruses in order to recover and be their healthiest selves. Unfortunately, this  is not a reality for many facilities. A healthcare facility that appears clean could actually be a hotspot for deadly Healthcare-Associated Infections (HAIs).

HAIs are infections that people acquire while they are receiving treatment for another condition in a healthcare facility (Centers for Disease Control and Prevention, 2016). The human digestive tract is home to many microorganisms, and most of them are harmless unless something upsets their balance within the body. Upsetting this balance can cause bacteria to grow and sicken patients, staff and visitors in any type of healthcare setting (University of Rochester Medical Center, 2016). Some bacteria that cause sickness, especially in healthcare settings, are Clostridium difficile (C. diff), vancomycin-resistant Enterococci (VRE) and methicillin-resistant Staphylococcus aureus (MRSA) (Reed and Kemmerly, 2009). C. diff, can grow or release toxins that attack the lining of the intestines. Vancomycin Resistant Enterococci (VRE) is a type of bacteria that has developed resistance to many antibiotics, namely vancomycin. Methicillin-resistant Staphylococcus aureus, also known as MRSA, is an infection caused by a type of staph bacteria that’s become resistant to many of the antibiotics used to treat ordinary staph infections (Reed and Kemmerly, 2009). The risks of contracting one of these HAIs can be reduced by hospital disinfection, which includes the cleanliness of soft surfaces such as cubicle curtains.

Results/Data/Outcomes

However, the dangers of HAIs can be lessened. It was reported that “(i)n 2011, there were an estimated 722,000 HAIs in acute care hospitals” and “about 75,000 patients with HAIs died during their hospitalizations,” which displays the importance of hindering these deadly infections (Centers for Disease Control and Prevention, 2016). Healthcare associated infections can be caused by infectious pathogens like fungi, viruses and bacteria (Reed, 2009). The Centers for Disease Control and Prevention (CDC) also reported, “about one in 25 hospital patients in the United States contracts at least one healthcare associated infection,” which further illustrates the widespread threat of HAIs (Centers for Disease Control and Prevention, 2016).

Healthcare associated infections are also becoming a financial burden for the government and patients alike. “Hospital-acquired infections result in up to $4.5 billion in additional healthcare expenses annually,” which shows how much money HAIs cost healthcare facilities, their patients and insurance companies (Reed and Kemmerly, 2009). New regulations from both Centers for Medicare Services (CMS) and insurance companies have eliminated reimbursements for HAIs that are deemed preventable, which places the burden on hospitals to do more to counteract these preventable infections.

HAIs can be prevented if hospitals maintain and clean rooms and all soft surfaces, including cubicle curtains. It has been stated that, “More than 70 percent of the bacteria that cause these infections are resistant to at least one of the antibiotics commonly used to treat them (FDA, 2016). Bacteria can be difficult to treat once it has infected a person, so thwarting it in the early stages while it is on a surface, prior to infection, is vital.

Cubicle curtains are a proven source of bacterial cross contamination

Cubicle curtains are a proven source of bacterial cross contamination (Rutala, 2013). A curtain can be touched by a patient, visitor or a nurse who could have an HAI on his or her hands. This can lead to a transfer of the HAI to another patient, visitor or staff member. 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.

Dr. William Rutala, director of the hospital epidemiology and occupational health and safety program at the University of North Carolina, conducted a study that offered a few solutions for the HAI issue. The first was to use a hydrogen peroxide product to decontaminate possibly infected curtains (Rutala, 2013) The use of hydrogen peroxide sprayed on the “grab area” of a curtain three times “was found to reduce approximately 98.5% of the pathogens on the privacy curtains,” (Rutala, 2013). This is significant because it shows that cubicle curtains and their potential to spread HAIs can be reduced. Another solution that was suggested was to “change curtains at discharge of patients on contact precautions; or use an antimicrobial privacy curtain,” in order to reduce the risk of HAIs, specifically ones that are spread through the soft surface of a cubicle curtain (Rutala, 2013).

Conclusion

Two things are happening in the medical and industrial worlds to make HAIs a non-factor. First, healthcare facilities are increasing the frequency of their cleaning efforts (Reed and Kemmerly, 2009). Facilities should understand the HAI threat statistics and reevaluate their methods to try to eliminate HAIs. The cleaning of cubicle curtains and the technology that is used to do so should continue to evolve and flourish. Consumer Reports’ ratings for infection control in U.S. hospitals were not incredibly high: “only 37 hospitals in the entire country got our highest rating in preventing each of the infections we measure,” further explaining the need for increased disinfection (Winters, 2014). Healthcare facilities can reduce the risk of HAIs in their areas by frequently laundering, cleaning or even disposing of (and recycling) their cubicle curtains. A second solution is a disposable curtain, which can be placed on any traditional track. Disposable/recyclable curtains seem to be most popular in isolated patient rooms because they are removed from the track after one use, disposed of, recycled and then replaced with a new curtain.

Advances are being made in the healthcare industry with the help of companies such as Construction Specialties that supply items such as bacteria-resistant curtains, easily removable fabric curtains and even disposable curtains. Taking precautions to ensure facility cleanliness and the health of patients, visitors and staff should be a top priority in the healthcare industry. Thus, properly cleaning and even replacing soft surfaces like curtains are important steps forward in eliminating the threat and spread of HAIs in the medical world.

References

1. Battle of the Bugs: Fighting Antibiotic Resistance. (2016, May 4). Retrieved from http://www.fda.gov/drugs/resourcesforyou/consumers/ucm143568.htm.
2. Centers for Disease Control and Prevention. (2016, March 2). HAI Data and Statistics. Retrieved from http://www.cdc.gov/hai/surveillance/.
3. Lybert, L. (2016, July). Seven aspects of surface selection. Health Facilities Management. Retrieved from http://www.hfmmagazine.com/articles/2273-seven-aspects-of-surface-selection.
4. Reed, D., and Kemmerly, S. A. (2009, Spring). Infection Control and Prevention: A Review of Hospital-Acquired Infections and the Economic Implications. The Ochsner Journal. 9(1) 27-31.
5. Rutala, B. (2013, March 31). Decontamination of hospital privacy curtains. Infection Control Report. Retrieved from http://infectioncontrolreport.blogspot.com/2013/03/decontamination-of-hospital-privacy.html.
6. Stroupe, J. M. (2010, February 1). Clean design. Health Facilities Management. Retrieved from http://www.hfmmagazine.com/articles/961?dcrPath=/templatedata/HF_Common/NewsArticle/data/HFM/Magazine/2010/Feb/1002HFM_FEA_Interiors.
7. University of Rochester Medical Center (2016). Viruses, Bacteria, and Parasites in the Digestive Tract. Health Encyclopedia. Retrieved from https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=90&ContentID=P02019.
8. Winters, C. (2014, November 15). Deadly hospital infections are still too common. Consumer Reports. Retrieved from http://www.consumerreports.org/cro/news/2014/11/deadly-hospital-infections-are-still-too-common/index.htm.