News archive - November 2013
Hospital curtains: the low-down
Over the past few years a large number of new-build hospital developments have been created, providing single-room accommodation for patients. However, the majority of hospitals in the UK still house people in multi-bed wards, traditionally with a curtain that can be pulled round each bay in order to provide a degree of privacy.
Historically these curtains have been made from fabric and are changed and cleaned as part of the wider laundry services policy.
But, over the past decade, as infection prevention and control and patient dignity have become NHS buzzwords, estates and facilities managers have had to think much more carefully about the products they purchase.
Firstly, boring neutral-coloured curtains are largely a thing of the past, with a number of manufacturers offering designer collections that fit with the interior design of hospital wards. For example, drapilux has expanded its 215 and 221 collections to include three new ranges of colourful designs.
A spokesman said: “Bare walls, cold lighting, sparse decorations - these are not the words generally used to describe an inviting atmosphere, and yet in many clinics, where a feel-good factor can have a significant effect on the recovery process, such a mundane atmosphere is still very much the standard.”
But how the curtains look is just one of several considerations hospital managers face when deciding which products to procure. And it is one of these drivers that has seen the biggest step change in the way curtains are selected.
Infection prevention and control plays a significant part in modern hospital procurement activity, and this is no less true for curtains. In response to this threat, in recent years an estimated 50% of hospitals in the UK have made the switch from fabric to disposable products.
In terms of cost, hospitals save on laundering bills as curtains are merely taken down and completely replaced every three to six months. Where a fabric curtain may cost in excess of £100, disposable equivalents are around £20 each. There is also a time saving as it can take more than 20 minutes to take traditional curtains down and another 20 minutes to hang new ones. Most disposable ranges can be pulled down in just two or three minutes and hung in around the same time.
Looking at the impact on infection control, research carried out by Floyd Trillis et al1 found that 42% of traditional fabric privacy curtains were contaminated with vancomycin-resistant enterococci, 22% with MRSA and 4% with C.difficile. The report states: “Our data suggests that hospital curtains have the potential to contribute to contamination of healthcare workers’ hands – the major source of transmission of nosocomial pathogens.”
Recognising this threat, drapilux has introduced antimicrobial bioaktiv fabrics, where silver ions are incorporated into the threads of its disposable range in order to destroy bacteria in the cell structure and help fight against harmful germs.
All In One Medical has also seen increased interest from the NHS for its disposable curtain ranges. Director, Tim Powell, told hdm: “Hospitals that have used disposable curtains have seen a marked reduction in infections such as norovirus, MRSA and C.difficile.”
Recognising the impact of interior design on the overall patient experience, All In One Medical has an eye-catching printed range, which includes options for children, teenagers and adults.
Marlux is another NHS supplier that offers disposable bug-busting curtains in a range of different designs.
A spokesman said: “Usually, hospital curtains are the only item not routinely changed before a new patient is admitted to hospital. Bed and lockers are disinfected, freshly laundered sheets and pillowcases are put on the bed, but the patient inherits the same dirty bed curtain from the last patient, the one before that, and the one before that.
“The very best NHS policy only intends to routinely change the cubicle curtains four times a year and many hospitals openly admit that they have no specific policy other than to ‘fire-fight’; changing curtains from one infection outbreak to the next”.
It has now produced a cost comparison chart2 which shows the capital cost of fitting conventional curtains into a six-bedded ward is around £1,950; while disposable curtains would cost £185.
Yewdale also manufactures and supplies a fire-retardant disposable curtain range with a unique Biosafe formula inherent within the fibres of the fabric, which prevents the growth of bacteria. Biosafe is the international accreditation standard of a proven antimicrobial formula that ensures effective inhibiting of infection. Tried and tested against the toughest strains, the formula forms a solid foundation to combat the forces of bacteria.
While there is a significant cost difference between traditional and disposable systems, there is an obvious demand for each product.
In some environments such as A&E and other high-use areas it makes sense to incorporate disposable curtains, whereas areas where patients are in hospital for the medium to long-term it seems patients respond better with traditional solutions in order that the environment feels more homely.
A spokesman for Yewdale said: “While some statistics state that disposable curtains are on the increase, it is a fact that the traditional polyester curtains are not diminishing. With the market of such curtains being £50m, a large proposition of this is in the healthcare sector.
“Along with the inherent qualities of the Biosafe anti-bacterial formula throughout, incorporating as standard a single join-free fabric with the use of colour on both sides, and always fire-retardant, Yewdale can guarantee that a better level of infection control can be maintained even after the curtain has been washed.”
But all good things come in threes and there is now a third option available, and one that takes infection control yet another step forward – dividing screens. These are increasingly being accepted as the infection control gold standard as they create hard surfaces, which can be cleaned and decontaminated every day and between patients in much the same way as bed rails, over-bed tables and chairs routinely are.
Tim Clarke, deputy managing director at Lisclare, which distributes Silentia screens, explained: “Our screens are hard surfaces that are integrated into part of the building by being attached to the wall. As the daily routine of cleaning beds, walls and floors is carried out, the screens become part of that and if something spills it can be wiped off immediately.”
What makes any system better than the other would be down to each individual, but the decision lies with them asking the question: Will this concept prevent or promote bacteria? Everyone knows that any decision made means they have to be able to justify it!
Screens also meet regulations in relation to privacy and dignity and it was for this reason that Silentia products were installed at Scotland’s Golden Jubilee National Hospital.
In total, 157 screens of seven or nine panels wide were installed in a white shade so they would show any staining and encourage cleaning.
Hospital housekeeper, Mary Filshie, said: “Before, if the curtains were dirty or had stains we had to get a porter to take them down, replace them with another curtain, and take the soiled one to the laundry for cleaning, so it could delay the use of the room and take the porter away from their duties. Now we have the screens we don’t have to get in touch with the porters. We clean each patient room once a day and also give them a check clean. The screens are cleaned with a damp cloth – a single cloth for each screen - with detergent or disinfectant when necessary.”
There is a high level of uncertainty around this new concept due to the fact that it doesn’t tie in with HTM66 cubicle track guidelines, nor are there specific guidelines for it.