Cubical Curtain Cleaning: How Often is Often Enough?
According to the American Society for Healthcare Environmental Services of the American Hospital Association, privacy curtains should be cleaned any time there is visible dust or soil and as a part of the terminal cleaning process whenever an area has been occupied by a patient who has been on contact or droplet precautions.1, 2 To prevent cross contamination, the privacy curtains should be taken down immediately after an area has been occupied by a patient who has been on isolation precautions, and clean curtains should be hung before the next patient occupies the area. Conversely, freshly laundered privacy curtains should be hung immediately before an immunosuppressed patient will be occupying the area.
If the curtains are made from a nonporous material (eg, plastic), the edges are high-touch areas and should be included in the daily disinfecting/cleaning procedure.1 If the curtains are fabric and there is no visible dust or soil, some of the following considerations should be taken into account for determining the frequency of cleaning: volume of surgical procedures performed per month, types of procedures performed in the facility, patient population, traffic in the area, and the number of visitors.
Privacy curtains should be removed and sent out to a commercial laundry to ensure they are disinfected and free of vegetative pathogens (ie, hygienically clean). According to the Centers for Disease Control and Prevention guidelines, “Laundering cycles consist of flush, main wash, bleaching, rinsing, and souring… . The antimicrobial action of the laundering process results from a combination of mechanical, thermal, and chemical factors.”2(p100-101) Adding a mild acid to the final rinse cycle is known as “souring” and results in a rapid shift in the pH from an alkaline level to an acidic level that further inactivates some microorganisms.2
The guidelines also state that large-surface cleaning methods that produce mists or aerosol or disperse dust in patient-care areas should be avoided.2 It is not appropriate to steam the curtains and leave them hanging because of the probability of aerosolization and dispersion of dust and the risk of burns to the personnel using the steamer. There also is a risk for inconsistency because the heat from the steam may not reach all areas of the curtain and may not provide enough heat to destroy microorganisms. Steam cleaning would not include the recommended bleaching and rinse cycles.
When purchasing privacy curtains and developing cleaning policies, perioperative managers should be aware of the manufacturer's recommendations for cleaning. State regulations or accrediting standards may dictate procedures for laundering and cleaning cycles. Knowing the fabric content of the privacy curtains is important to determine the method for cleaning. For example, dry cleaning is not considered to be effective in reducing the numbers of bacteria and viruses on contaminated fabric surfaces.2 Fabric content also is important because of the tendencies of microorganisms to bind with certain fabrics more than others. One study indicates that S aureusand Pseudomonas aeruginosa can bind to acrylic, polyester, and wool at very high ratios.3 Other studies have shown that staphylococci, enterococci, and fungus can survive on fabric for days or weeks and have a tendency to survive longer on polyester than on cotton.4, 5 A sufficient inventory of privacy curtains should be purchased to allow immediate replacement when necessary.
by Bonnie G. Denholm
MS, BSN, RN, CNOR
Perioperative Nursing Specialist
AORN Center for Nursing Practice
1. FAQ section: how often should privacy curtains be cleaned?. American Society for Healthcare Environmental
Services of the American Hospital Association
http://www.ashes.org/ashes_app/learn/in_focus/faqs/privacy_curtains_1.jsp Accessed November 11, 2010
Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC).
Guidelines for Environmental Infection Control in Health-Care Facilities:Chicago IL: American Society for Healthcare Engineering/American Hospital Association;
2004; http://cdc.gov/ncidod/dhqp/pdf/guidelines/Enviro_guide_03.pdf Accessed January 7, 2011
materials. . Distinctive bacteria-binding property of cloth Am J Infect Control. 2004;32(1):27–30
4. . Survival of some medically important fungi on hospital fabrics and plastics. J Clin Microbiol.
5. . Survival of enterococci and staphylococci on hospital fabrics and plastic. J Clin Microbiol.