A new survey published in the November issue of the American Journal of Infection Control (AJIC) reveals that evaluation of current infection prevention policies, and staff adherence to those policies, can reveal gaps in practice and opportunities for improving patient safety.  According to the authors of the article, establishing a baseline is important in determining where to apply interventions as well as for evaluating success. They go on to state, “We believe that identifying the gaps and addressing them as a system will help lead to marked improvements in safety for our patients.”[1]

Infection preventionists and quality and safety directors should consider all aspects of the healthcare environment when reviewing procedures. While this article does not specifically look at standards for fabrics in the patient care environment (i.e., lab coats, privacy curtains, bed linens), leaving these out could be potentially dangerous.  Studies have identified gram positive bacteria, including those that are multi-drug resistant, can survive on cotton and polyester – common materials for healthcare fabrics.[2] Moreover, high touch surfaces such as privacy curtains represent a greater risk due to infrequent changing and laundering. A 2012 study published in the American Journal of Infection Control identified 92 percent of privacy curtains sampled were contaminated within one week and “eight curtains yielded VRE at multiple time points: 3 with persistence of a single isolate type and 5 with different types, suggesting frequent recontamination.”[3]

Healthcare fabrics have been proven to be contaminated and deserve as much attention as other fomites such as hard surfaces and hands. A thorough evaluation of current practice regarding product selection, laundering and staff behavior is an important first step in identifying areas for improvement. For instance, the infection preventionist could assess procedures for laundering different types of fabrics in the facility, including frequency, staff responsibility and reporting/tracking. Moreover, an assessment of healthcare workers’ understanding of the dangers of contaminated fabrics could help facilities understand education needs in this area. If staff is not thinking about fabrics and a clean hand pulls back a contaminated privacy curtain or reaches into a dirty pocket before touching a patient, the risk for cross contamination is still present. For a comprehensive look at the contamination of fabrics and how to conduct a risk assessment, download our new whitepaper.

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[1] Evaluation of Hospital Infection Prevention Policies Can Identify Opportunities for Improvement. Accessed November, 22, 2013. http://www.infectioncontroltoday.com/news/2013/10/evaluation-of-hospital-infection-prevention-policies-can-identify-opportunities-for-improvement.aspx

[2] Neely AN and Maley MP. Survival of enterococci and staphylococci on hospital fabrics and plastic. J Clin Micro. Vol. 38, No. 2. February 2000. Pp. 724-726.

[3] Ohl et al. Hospital privacy curtains are frequently and rapidly contaminated with potentially pathogenic bacteria. Am J of Inf Control. Online publication. 2012 http://www.ajicjournal.org/article/S0196-6553%2812%2900070-3/abstract