---
title: I think my dear Watson the culprit was the Privacy Curtain.....
description: I think my dear Watson the culprit was the Privacy Curtain.....
---

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## I think my dear Watson the culprit was the Privacy Curtain.....

<http://static1.squarespace.com/static/595689fc9de4bbc892200518/t/59568ace5fd63b5f29287988/1498845258881//img.png.com/static/595689fc9de4bbc892200518/t/59568ace5fd63b5f29287989/1498843854132/1000w/>

What I find so interesting about the field of infection  
 control and the prevention of infections is the fact that on almost a daily  
 basis you can have an "AH-HA" moment that has the potential to change  
 our current ways of practice. 

Ferreting out the "culprit or culprits" that  
 could be a reservoir for potentially pathogenic organisms is very much like  
 playing [Sherlock](http://en.wikipedia.org/wiki/Sherlock_Holmes). Nothing is elementary; everything has the potential to be the  
 prime suspect. Our investigations need to move beyond the obvious, we need to  
 start looking outside of the box and consider that perhaps we have not  
 identified ALL of the high touch surfaces that have the potential to  
 contaminate hands.

I think it would be safe to say that most of us do not  
 give much thought to hospital privacy curtains except to perhaps think  
 "boy that is an ugly pattern or colour". I would even hedge a bet  
 that if you were to review your facility's infection prevention and control  
 policies you would find only a small statement (if anything at all) that  
 mentions that they should be changed when visibly soiled and/or after  
 completing a terminal clean of an Isolation Room.

I mean they're curtains for Pete’s sake!  Why would we give them another thought? To  
 answer that question perhaps we should conduct a study that investigates how  
 many times privacy curtains are touched on a daily basis by healthcare workers  
 (HCWs), patients and visitors. Like studies that look at the number of cars  
 that pass through a particular intersection to determine traffic flow etc, I  
 think we would be blown away by the frequency this seemingly innocuous surface  
 is touched.  

In a study recently published in AJIC, [Ohl et al](http://www.ncbi.nlm.nih.gov/pubmed/22464039)  
 investigated the persistence of bacterial contamination on privacy curtains  
 over a 3 week period.  Of the 43 curtains  
 tested in the study, 95.5% showed contamination on at least 1 occasion and the  
 13 curtains that were changed during this time period showed that within a week  
 92.3% of the new curtains were found to be contaminated with pathogens  
 associated with HAIs. 

AH-HA moment #1 - CURTAINS ARE CONTAMINATED!!!

Now that we know the curtains are contaminated, what  
 impact do they play with hand hygiene and how do we clean/disinfect them? Realistically,  
 HCWs are quite likely to touch the curtains after they have performed HH and  
 donned gloves but before performing patient care activities. Yes, HH was  
 completed, but have we now just unwittingly contaminated our hands by touching  
 the curtain? 

AH-HA moment #2 - CURTAINS CAN LIKELY CONTAMINATE  
 HANDS! 

Now, how on earth can we clean/disinfect them or put  
 procedures into place that can eliminate or reduce contamination? This is where  
 we need more science; however, there was a poster presented by [Price et al](http://www.ajicjournal.org/article/S0196-6553(12)00346-X/fulltext) at  
 the 2012 APIC conference that used H2O2 to clean the leading edge of the  
 curtain where contact was most likely and showed that yes, one can conceivably  
 implement a cleaning strategy that can help to reduce contamination. Using a 3%  
 H202 solution did significantly reduce the bio-burden load on the curtain  
 within 5 minutes and continued to show a decrease up to 2 hrs post application.  
 Another alternative could be the use of barriers. Similar to a dental operatory  
 where barrier covers are routinely used, we could consider applying a barrier  
 cover on the leading edge of the curtain that can be changed perhaps on a daily  
 basis to help reduce contamination.

AH-HA moment #3 - WE NEED TO IMPLEMENT A PROCESS TO  
 REDUCE CURTAIN CONTAMINATION

We still have a lot of sleuthing left to do my dear  
 Watson, but knowing that HCWs, patients and visitors frequently touch curtains  
 and knowing that touching contaminated surfaces can contaminate hands suggests  
 the potential for transmission of pathogenic organisms from curtains to hands  
 to patients.  Perhaps we need to consider  
 that privacy curtains are a high touch surface that can be a significant source  
 of pathogenic contamination.

*Bugging Off!*

Nicole

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