BLEND
Evidence is growing that pathogens in hospital curtains are an infection risk. George Winter reports
Curtains hide risks to health and hygiene
NURSING STANDARD
describe an outbreak of invasive group A streptococcus (GAS) infection involving hospital curtains as a potential source of infection.
Harbouring bugs
The outbreak began when two laryngeal cancer patients on an ENT ward developed invasive GAS infection. Screening identified one additional patient with the infection, as well as a healthcare worker who later developed pharyngitis. Researchers discovered that ten out of 34 patient curtains on the ward
SUMMARY
Hospital curtains preserve patients’ modesty and afford a degree of privacy when sensitive matters are discussed. But they are also good at harbouring bugs. In a 2012 United States study (Ohl M et al, American Journal of Hospital Infection), 43 curtains in two intensive care units and a medical ward were swabbed over a three-week period. Forty-one (95 per cent) curtains were found to be contaminated at least once, 21 per cent with MRSA and 42 per cent with vancomycin-resistant enterococcus. In addition, 12 of 13 curtains (92 per cent) that were newly installed became contaminated within a week. A 2014 study by researchers at Nottingham University Hospitals NHS Trust (Mahida N et al, Journal of Hospital Infection) is the first to
were contaminated with GAS, and all GAS isolates were of an identical strain. Tim Boswell, consultant microbiologist and member of the Nottingham research team, says the infection risk posed by curtains has been overlooked. ‘Curtains are often the only item around a patient’s bed space area that isn’t routinely removed for laundering. Any fabric can harbour bugs such as MRSA and, as we have shown, GAS.’ The study found that GAS pathogens were likely to have contaminated the curtains through ‘direct
Curtains around hospital beds can harbour pathogens that pose an infection risk to patients and staff. A recent study by researchers at a Nottingham hospital identified curtains as a potential source of an outbreak of group A streptococcus (GAS) infection. Good hand hygiene is crucial to reduce the risks of contamination. Author George Winter is a freelance journalist
droplet spread and contact with contaminated hands’. RCN adviser on infection prevention and control, Rose Gallagher, says: ‘This article is a clear reminder of the importance of fundamental infection control practices such as hand hygiene before contact with patients, and thorough cleaning after outbreaks or clusters of infection. ‘GAS infections should not be underestimated due to their potential to cause serious infection, particularly in crowded hospital settings where spread can easily occur.’ A Freedom of Information (FOI) request earlier this year revealed that curtains at the Royal London Hospital are changed three times a year, ‘or sooner if soiled’. The Royal Infirmary of Edinburgh responded to another FOI request by referring to a national cleaning services specification stating that patient curtains on low-risk wards be changed twice a year, and in high-risk areas – such as intensive care units – once a month. Dr Boswell says his trust is considering how to minimise the risks. ‘We have re-visited the frequency of curtain laundering, but no firm decisions have been made. There are alternatives to consider, such as disposable curtains, and wipeable, cleanable privacy screens.’ A further option is decontamination by spraying curtains. A 2014 report in the American Journal of Infection Control (Rutala W et al) described how spraying with an ‘improved’ hydrogen peroxide solution reduced the microbial load on the privacy curtains by 96.8 per cent in 37 patient rooms NS
july 16 :: vol 28 no 46 :: 2014 27
Downloaded from RCNi.com by ${individualUser.displayName} on Nov 23, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
Evidence is growing that pathogens in hospital curtains are an infection risk. George Winter reports
Curtains hide risks to health and hygiene
NURSING STANDARD
describe an outbreak of invasive group A streptococcus (GAS) infection involving hospital curtains as a potential source of infection.
Harbouring bugs
The outbreak began when two laryngeal cancer patients on an ENT ward developed invasive GAS infection. Screening identified one additional patient with the infection, as well as a healthcare worker who later developed pharyngitis. Researchers discovered that ten out of 34 patient curtains on the ward
SUMMARY
Hospital curtains preserve patients’ modesty and afford a degree of privacy when sensitive matters are discussed. But they are also good at harbouring bugs. In a 2012 United States study (Ohl M et al, American Journal of Hospital Infection), 43 curtains in two intensive care units and a medical ward were swabbed over a three-week period. Forty-one (95 per cent) curtains were found to be contaminated at least once, 21 per cent with MRSA and 42 per cent with vancomycin-resistant enterococcus. In addition, 12 of 13 curtains (92 per cent) that were newly installed became contaminated within a week. A 2014 study by researchers at Nottingham University Hospitals NHS Trust (Mahida N et al, Journal of Hospital Infection) is the first to
were contaminated with GAS, and all GAS isolates were of an identical strain. Tim Boswell, consultant microbiologist and member of the Nottingham research team, says the infection risk posed by curtains has been overlooked. ‘Curtains are often the only item around a patient’s bed space area that isn’t routinely removed for laundering. Any fabric can harbour bugs such as MRSA and, as we have shown, GAS.’ The study found that GAS pathogens were likely to have contaminated the curtains through ‘direct
Curtains around hospital beds can harbour pathogens that pose an infection risk to patients and staff. A recent study by researchers at a Nottingham hospital identified curtains as a potential source of an outbreak of group A streptococcus (GAS) infection. Good hand hygiene is crucial to reduce the risks of contamination. Author George Winter is a freelance journalist
droplet spread and contact with contaminated hands’. RCN adviser on infection prevention and control, Rose Gallagher, says: ‘This article is a clear reminder of the importance of fundamental infection control practices such as hand hygiene before contact with patients, and thorough cleaning after outbreaks or clusters of infection. ‘GAS infections should not be underestimated due to their potential to cause serious infection, particularly in crowded hospital settings where spread can easily occur.’ A Freedom of Information (FOI) request earlier this year revealed that curtains at the Royal London Hospital are changed three times a year, ‘or sooner if soiled’. The Royal Infirmary of Edinburgh responded to another FOI request by referring to a national cleaning services specification stating that patient curtains on low-risk wards be changed twice a year, and in high-risk areas – such as intensive care units – once a month. Dr Boswell says his trust is considering how to minimise the risks. ‘We have re-visited the frequency of curtain laundering, but no firm decisions have been made. There are alternatives to consider, such as disposable curtains, and wipeable, cleanable privacy screens.’ A further option is decontamination by spraying curtains. A 2014 report in the American Journal of Infection Control (Rutala W et al) described how spraying with an ‘improved’ hydrogen peroxide solution reduced the microbial load on the privacy curtains by 96.8 per cent in 37 patient rooms NS
july 16 :: vol 28 no 46 :: 2014 27
Downloaded from RCNi.com by ${individualUser.displayName} on Nov 23, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
