Privacy Curtains Research Articles

Assessment of Medical-Surgical Patients' Perception of Hospital Noises and Reported Ability to Rest.

The purpose was to determine if an enhanced privacy curtain (1) impacted ability to rest while hospitalized in the acute care setting and (2) improved patient satisfaction associated with environmental noise. The project evaluated a privacy curtain designed to increase speech privacy and intelligibility and reduce reverberation time (echo). The curtain was similar to the existing privacy curtain with 2 exceptions: the curtain panel had pocket inserts that absorbed sound, and curtain panels could be zipped together to reduce sound transmission through gaps. Curtains were evaluated on 2 medical-surgical units. Patients with at least 2 nights' stay and were alert and oriented without behavioral concerns were asked to complete a 12-item restful environment assessment. The project demonstrated some impact on ability to rest. One unit saw an increase in the patient experience sleep measure score and demonstrated a small increase in the patient's self- reported ability to rest during the day and night when using the enhanced curtain. Patients on medical-surgical units were bothered by the noises typically heard in those units. Small improvements in patient experience with the enhanced curtain were outweighed by cost and increased housekeeping and laundry staff workload.

Rate of contamination of hospital privacy curtains on a burns and plastic surgery ward: a cross-sectional study

Surfaces in the patient environment may play a role in microbial transmission if they become colonized by bacteria. Patient privacy curtains are one such surface that may pose a high risk for transmission because they are high-contact surfaces, are infrequently cleaned, and healthcare workers are less likely to wash their hands after contacting inanimate objects such as curtains. To determine the amount and type of bacterial colonization of patient privacy curtains at a regional burns/plastic surgery unit. Privacy curtain contamination on the burns/plastic surgery ward was determined for two separate occasions six months apart: 23 curtains on August 2015 and 26 curtains on January 2016. Dey-Engley neutralizing agar (DENA) replicate organism detection and counting (RODAC) contact plates were used daily to sample curtains near the edge hem where they are most frequently touched. Microbial contamination was reported as cfu/cm2 and the presence of meticillin-resistant Staphylococcus aureus (MRSA) was determined. Swabs were also taken of any open wounds and from tracheostomy sites on the ward. Curtain contamination in August 2015 was 0.7-4.7 cfu/cm2 with 22% testing positive for MRSA, whereas contamination on January 2016 was 0.6-13.3 cfu/cm2 with 31% of curtains testing positive for MRSA. Curtains on the burns/plastic surgery ward become colonized with significant quantities of bacteria. Future studies will need to address the rate of colonization and the clinical impact of this colonization to better inform cleaning protocols.

Successful Environmental Disinfection to Prevention Transmission of Candida Auris

Background Candida auris is a globally-emerging, multidrug-resistant yeast causing invasive infections and can persist on environmental surfaces if not adequately disinfected. Last summer, two patients with C. Auris infections were admitted at University of Chicago Medicine (UCM). Environmental samples were collected to assess environmental contamination before and after cleaning.Methods Environmental samples were collected using 3M Sponge Sticks with neutralizing Buffer during one patientÕs stay, weeks after another patientÕs stay, and after enhanced terminal cleaning. Samples were cultured directly and yeast was identified using MALDI. The following surfaces were sampled: Bathroom sink drain, bedside table, bedrail, mattress, chair and window ledge. Routine terminal cleaning includes 10% sodium hypochlorite solution applied high touch surfaces of both room and bathroom. The enhanced terminal cleaning process used for these rooms included: (1) 10% sodium hypochlorite solution applied to all high touch surfaces and walls; (2) privacy curtains removed and replaced; (3) supervision by environmental services manager; and (4) single UV disinfection cycle in room and bathroom.ResultsBecause of delay in identification of C auris for the first patient, pre-clean samples were taken >2 weeks after the patient had been discharged. During the intervening weeks, multiple patients had occupied the room and there had been >3 routine terminal cleanings. None of these samples were positive for C auris. Pre-clean, in-residence samples indicated C auris contamination of multiple surfaces for the second patient. Because of transfers within the institution, there are three sets of post-cleaning cultures for the second patient. All post-clean environmental cultures were negative for both patients. Results are shown in Figure 1.Conclusion Candida auris can contaminate environmental surfaces. While routine terminal cleaning may have been effective in removing C auris from surfaces in one patientÕs room, the enhanced terminal cleaning strategy used here was effective in our facility.Disclosures J. P. Ridgway, Gilead FOCUS: Grant Investigator, Grant recipient

Acquisition of bacteria on health care workers' hands after contact with patient privacy curtains.

To determine whether pathogenic bacteria could be transferred to health care workers by touching privacy curtains, imprints of health care workers' fingertips were obtained when participants were approached, after hand hygiene with alcohol handrub, and directly after handling curtains. Participants' hands were heavily contaminated at baseline, in some cases with potentially pathogenic species. Half of the participants (n = 30) acquired bacteria on their fingertips from handling curtains, illustrating that privacy curtains may be involved in the transmission of infection to emergency department patients.

Acoustic assessment of speech privacy curtains in two nursing units.

Hospitals have complex soundscapes that create challenges to patient care. Extraneous noise and high reverberation rates impair speech intelligibility, which leads to raised voices. In an unintended spiral, the increasing noise may result in diminished speech privacy, as people speak loudly to be heard over the din. The products available to improve hospital soundscapes include construction materials that absorb sound (acoustic ceiling tiles, carpet, wall insulation) and reduce reverberation rates. Enhanced privacy curtains are now available and offer potential for a relatively simple way to improve speech privacy and speech intelligibility by absorbing sound at the hospital patient's bedside. Acoustic assessments were performed over 2 days on two nursing units with a similar design in the same hospital. One unit was built with the 1970s’ standard hospital construction and the other was newly refurbished (2013) with sound-absorbing features. In addition, we determined the effect of an enhanced privacy curtain versus standard privacy curtains using acoustic measures of speech privacy and speech intelligibility indexes. Privacy curtains provided auditory protection for the patients. In general, that protection was increased by the use of enhanced privacy curtains. On an average, the enhanced curtain improved sound absorption from 20% to 30%; however, there was considerable variability, depending on the configuration of the rooms tested. Enhanced privacy curtains provide measureable improvement to the acoustics of patient rooms but cannot overcome larger acoustic design issues. To shorten reverberation time, additional absorption, and compact and more fragmented nursing unit floor plate shapes should be considered.

Hospital curtains: An undermined source of nosocomial infections.

Sir, Contact hygiene is often a neglected subject in most hospital settings, particularly with regards to contact with the patient environment in a hospital setting. The purpose of this letter is to emphasize the role of patient bedside curtains in the transmission of microbial pathogens. Various disease-associated bacteria are transferred from person to person via hospital equipment including bedside curtains, which are categorized as “high touch” surfaces by the Center for Disease Control and Prevention.[1] Various outbreaks of hospital-acquired pathogens and their transmission have been reported in clinics, inpatient wards, and Intensive Care Units (ICUs). Bedside, curtains are frequently directly touched by patient's hands, as well as the nursing staff and the visitors. This, in particular, makes all health-care workers, patients, and visitors vulnerable of transmitting disease-causing pathogens among each other. Numerous human pathogens have been identified in hospital and clinic curtains. These include Micrococcus species (sp.), Bacillus sp., Escherichia coli, coagulase-negative Staphylococcus, and Staphylococcus aureus. Some of these bacteria may still persist even after laundry of curtains and become potential causes of infectious diseases, particularly in hospitalized patients with attenuated immune systems. In a survey where curtains were cleaned every 4 months reported, 42% vancomycin-resistant enterococci (VRE), 22% methicillin resistant S. aureus (MRSA), and 4% Clostridium difficile using contact plates and swabbing technique. Most contamination was found in privacy curtains of isolation rooms. Ninety-two percent of the privacy curtains in the hospital wards and ICUs to be contaminated with bacteria as determined by culture swabs.[2] Most of the hospital curtains were harboring MRSA and VRE, posing a potential pathogenic threat to the patient and their house staff. Despite proper laundry, patient side curtains were reported to be contaminated within a week after they were replaced. If this trend of pathogenic transmission continues, there is a potential danger that newer, drug-resistant bacteria may evolve, providing a challenge to health-care providers to limit the spread of nosocomial infections. There was an epidemic of Acinetobacter baumannii in ICU settings of a tertiary care hospital in Birmingham (United Kingdom) in 2002, where bedside curtains were identified as the primary source of carbapenemase-producing Acinetobacter species, which were resistant to meropenem.[3] Similarly, in a recent outbreak of Group A Streptococcus (GAS) infection in ENT ward in Nottingham (UK), 10 out of 34 bedside curtains identified as reservoirs of GAS.[4] These data highlight the importance of recognizing hospital curtains as a potential reservoir of microbial pathogens. It is imperative for health-care facilities to set an appropriate frequency of changing bedside curtains and promote contact hygiene to minimize a risk of bacteria transmission. This should be based on patient discharge and the institutional prevalence of microbial pathogens such as MRSA. It is crucial to adapt decontamination protocols to ensure effective elimination of microbes from hospital curtains. Besides contact hygiene before and after a patient interaction, one intervention suggested to spray 3% hydrogen peroxide to reduce curtain contamination. This technique is able to decontaminate bedside curtains after 2 h.[5] It is understandable that several factors contribute to the hurdles in achieving high disinfect rates; sustained efforts should be implemented to identify and control the spread of infectious agents that are transferred by contacting hospital curtains. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

1387Effectiveness of a Sporicidal Disinfectant Spray for Disinfection of Hospital Privacy Curtains

1387Effectiveness of a Sporicidal Disinfectant Spray for Disinfection of Hospital Privacy Curtains

Hydrogen Peroxide Exposure from Spraying Patient Privacy Curtains

protection was the lack of accessibility 53%; not a priority in an emergency (47%) or not necessary (27%). 53% reported that face protection is available in or just outside the patient’s room. 70% wanted it available in or just outside the room. 37% reported they would use it if it were more accessible and 35% reported being in a situation inwhich they regretted not wearing face protectionwhile suctioning. LESSON LEARNED: Access to face protection supplies is inconsistent within our hospital. We learned we need to identify standard locations to store masks and eye protection, as improved accessibility may increase use by staff. Most staff would like face protection to be available either inside or directly outside of the room. Continuing education is needed regarding situations in which face protection is indicated for standard precautions.

The silver lining of disposable sporicidal privacy curtains in an intensive care unit

The environment is a well-known source of health care-acquired infection. Because of the known risk of contamination, patient privacy curtains require frequent changes to decrease the risk of spread from patients to curtain and visa versa. Fourteen disposable sporicidal privacy curtains were tested from December 2012 to June 2013 while hanging in a busy intensive care unit. Significant bacterial pathogens were identified and total bacteria enumerated as colony-forming units. Antimicrobial activity of curtain swatches was also tested against a range of bacteria in the laboratory. Measurements were recorded as zone of inhibition and contact inhibition. A cost analysis to replace standard curtains with disposable sporicidal curtains was also undertaken. Cultures grew low numbers of skin and environmental microorganisms with no methicillin-resistant Staphylococcus aureus, carbapenem-resistant Enterobacteriaceae, or Clostridium difficile detected. Vancomycin-resistant enterococci were recovered in very low numbers from 2 curtains where vancomycin-resistant enterococci-infected patients had been located. Privacy curtains demonstrated antimicrobial activity against C difficile and 13 additional bacterial pathogens. We conclude that disposable sporicidal privacy curtains are cost-effective and best replaced at 6 months in a high-risk area such as an intensive care unit.

Effectiveness of improved hydrogen peroxide in decontaminating privacy curtains contaminated with multidrug-resistant pathogens

We tested the ability of an improved hydrogen peroxide solution to decontaminate privacy curtains in inpatient and outpatient areas. The microbial contamination of the curtains was assessed before and after the curtains were sprayed with improved hydrogen peroxide. The disinfectant reduced the microbial load on the privacy curtains by 96.8% in 37 patient rooms.

A pilot observational study of hydrogen peroxide and alcohol for disinfection of privacy curtains contaminated by MRSA, VRE and Clostridium difficile.

Privacy curtains, frequently used in hospitals to separate patient care areas may have an important role in the transmission of healthcare-associated pathogens. In this pilot study, we inoculated curtain swatches with suspensions of clinical specimens of meticillin resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococcus (VRE), and Clostridium difficile before using a gloved hand to touch the inoculated curtain swatch and transfer to clean agar plates. Three different commonly used disinfectants were then sprayed onto these swatches before using a clean gloved hand to touch the swatch and transfer onto new agar plates. All plates were incubated at 35°C for 24 and 72 h. Bacterial growth before and after disinfection was assessed and compared. 3.1% hydrogen peroxide effectively eliminated transfer of C. difficile, MRSA and VRE from inoculated curtains.

A Comparison of Disinfectants on the Efficacy of Cleaning Privacy Curtains

A Comparison of Disinfectants on the Efficacy of Cleaning Privacy Curtains

Hospital Privacy Curtains: Cleaning and Changing Policies - Are We Doing Enough?

The importance of environmental contamination and risk of certain infections in the acute and ambulatory care settings is well known. Hospital privacy curtains have been shown to be contaminated with healthcare-associated pathogens. We sought to investigate the cleaning and changing policies for hospital privacy curtains in West Virginia, Pennsylvania, Ohio, Kentucky, Virginia, and Maryland.

Clinic Exam Room Design: Present and Future

This article aims to deconstruct various design qualities and strategies of clinic exam rooms, and discuss how they influence users' interaction and behavior in the space. Relevant literature supports the advantages and disadvantages of different design strategies. Annotated exam room prototypes illustrate the design qualities and strategies discussed. Advancements in technology and medicine, along with new legislative policies, are influencing the way care providers deliver care and ultimately clinic exam room designs. The patient-centered medical home model has encouraged primary care providers to make patients more active leaders of their health plan which will influence the overall functionality and configuration of clinic exam rooms. Specific design qualities discussed include overall size, location of doors and privacy curtains, positioning of exam tables, influence of technology in the consultation area, types of seating, and placement of sink and hand sanitizing dispensers. In addition, future trends of exam room prototypes are presented. There is a general lack of published evidence to support design professionals' design solutions for outpatient exam rooms. Future research should investigate such topics as the location of exam tables and privacy curtains as they relate to patient privacy; typical size and location of consultation table as it relates to patient connection and communication; and placement of sinks and sanitization dispensers as they relate to frequency and patterns of usage. Literature review, outpatient, technology, visual privacy.

Novel Hospital Curtains with Antimicrobial Properties: A Randomized, Controlled Trial

Privacy curtains that separate patient care areas in hospitals may play an important role in the transmission of healthcare-associated pathogens. The aim of this randomized, controlled trial was to assess the effectiveness in a clinical setting of curtains incorporating a complex element compound (CEC) with antimicrobial properties. Twenty-one rooms in a surgical intensive care unit (ICU) and 9 rooms in a medical ICU were randomly selected to receive either a new standard curtain or a new identical-looking CEC curtain. Fifteen rooms received CEC curtains and 15 received standard curtains. Cultures were performed of samples that were collected from curtains twice a week for 4 weeks (23 days). Contamination was determined according to standard microbiologic methods. Time to contamination was assessed with the Wilcoxon rank-sum test and survival analysis. Incidence rates of contamination were compared using Poisson regression. The median time to first contamination was 7 times longer for CEC curtains than for standard curtains (14 vs 2 days; [Formula: see text]). CEC curtains were significantly less contaminated than standard curtains according to earlier culture results but not significantly different for later culture results. Fourteen CEC curtains and 13 standard curtains were contaminated at least once ([Formula: see text]). The adjusted rate of contamination was 29% lower among CEC versus standard curtains, but this was not statistically significant (rate ratio, 0.71; 95% CI, 0.48-1.07). CEC privacy curtains increase the time to first contamination as compared with standard curtains. Use of privacy curtains with antimicrobial properties could increase the time between washings and may potentially play a role in decreasing pathogen transmission.

Hydrogen Peroxide Privacy Curtain Cleaning Study

Collaboration between Infection Prevention and Environmental Services (EVS) is becoming more important on a national level and in our healthcare system. With patient safety in the forefront of healthcare, it's imperative to have better control over potential environmental reservoirs of pathogenic organisms. The Infection Preventionists (IPs) and EVS performed a literature review to assess for standards regarding patient privacy curtain cleaning. Little evidence was found from scientific investigation, regulatory agencies or in standards of practice.

Hospital privacy curtains are frequently and rapidly contaminated with potentially pathogenic bacteria

Privacy curtains are a potentially important site of bacterial contamination in hospitals. We performed a longitudinal study to determine the prevalence and time course of bacterial contamination on privacy curtains. Over a 3-week period, swab cultures (n= 180) were obtained twice weekly from the leading edge of 43 curtains in 30 rooms in 2 intensive care units and a medical ward. Curtains were marked to determine when they were changed. Contamination with Staphylococcus aureus, methicillin-resistant Saureus (MRSA), Enterococcus spp, vancomycin-resistant enterococcus (VRE), or aerobic gram-negative rods was determined by standard microbiologic methods. To distinguish persistence of pathogens on curtains from recontamination, all VRE and MRSA were typed using pulsed-field gel electrophoresis. Twelve of 13 curtains (92%) placed during the study showed contamination within 1 week. Forty-one of 43 curtains (95%) demonstrated contamination on at least 1 occasion, including 21% with MRSA and 42% with VRE. Eight curtains yielded VRE at multiple time points: 3 with persistence of a single isolate type and 5 with different types, suggesting frequent recontamination. Privacy curtains are rapidly contaminated with potentially pathogenic bacteria. Further studies should investigate the role of privacy curtains in pathogen transmission and provide interventions to reduce curtain contamination.

Infection control ‘undercover’: a patient experience

Please cite this article in press as: Dancer doi:10.1016/j.jhin.2011.12.003 As a National Health Service microbiologist and former editor of the Journal of Hospital Infection, most of my professional time is spent managing nosocomial infection. Becoming a patient was not part of the job plan until a sudden accident on holiday compelled hospital admission. It was an opportunity to experience infection control in the real world and one that could not be ignored. Bedbound, and ‘undercover’, this patient witnessed the ward-based impact of infection control in hospitals in two countries. The accident dislodged three intervertebral discs, warranting immediate admission into an acute trauma ward in Italy. There were no privacy curtains; no lights other than a fluorescent ceiling strip; no nurse call button; no electrical equipment; no soft furnishings; and no alcohol gel. There is an expectation that relatives provide basic hospital care in this part of Italy, and this, in part, reflected the paucity of nursing staff. The ward sink was used only by visitors. None of the doctors cleaned their hands during the ward rounds, despite moving from patient to patient. No hand hygiene opportunities were offered to patients after toileting, nor before or after eating. If hands were ignored, basic cleaning certainly was not. Given minimal clutter in the bay, two domestic personnel obtained easy access to all dark corners. The floor was vacuumed, then mopped, and all beds and lockers moved for cleaning purposes. Window blinds, cupboard, door handles, wall fixtures

Clinical Issues—May 2011

This MonthFormalin storage and handlingKey words: formalin, formaldehyde, specimen handling.Immediate‐use sterilizationKey words: flash sterilization, immediate‐use sterilization.Precautions for treating patients with multidrug‐resistant organismsKey words: multidrug‐resistant organisms, MDRO, methicillin‐resistant Staphylococcus aureus, MRSA.Cleaning privacy curtainsKey words: environmental cleaning, privacy curtains, laundering, commercial laundry.Informed consentsKey words: surgical consent, implants, brand names, generic names.

Going Under

Going Under