Reusable vs Disposable hospital privacy curtains

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To reuse or not to reuse?
In recent years there’s been growing hype surrounding the perceived infection control advantages of disposable privacy curtains in hospitals, but are we overlooking the benefits afforded by reusable curtains?

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While disposable privacy curtains are great for high infection areas where it’s important to be able to gather up all items for incineration, research gathered over the past decade suggests that the physical environment can significantly improve patient outcomes and expedite patient recovery ^(1,2).
A less “clinical” physical environment helps patients relax and recover quicker, therefore in wards and other treatment areas it’s important to create a homely feel. Reusable privacy curtains made of woven fabric add warmth and improve acoustic amenity, resulting in a dignified atmosphere conducive to patient recovery.
Given the above, decision makers face a dilemma when it comes to balancing infection control, ease of use and patient health outcomes.
Data gathered by linen services consultants Graham Jowsey & Associates sheds some light on common misconceptions surrounding both disposable and reusable privacy curtains and helps to establish the relative effectiveness of both options.
The source of the data is one major linen service provider and two hospital groups, one based in Sydney and the other in Melbourne.
Life expectancy
Both hospital groups advised that a good quality reusable curtain can last up to ten years if maintained in the correct fashion (i.e. washed to Australian Standard 4146), although there are a small proportion of stains, like with all hospital linen, that cannot be washed out.
On the other hand, a disposable curtain can hang for up to 12 months providing there is no obvious staining or wear-and-tear. That being said, this is very much dependent on individual facilities infection control (IC) protocols. In some instances, it is protocol to take down a disposable curtain after three months.
Washing costs
The ongoing washing costs associated with reusable privacy curtains are often used to support the cost effectiveness of disposable curtains, but the frequency of washing (and hence washing costs) largely depends on the IC policies of individual facilities. One hospital reported that the cleanliness of privacy curtains is inspected by ward staff daily, with soiled curtains being replaced immediately. The other advised their protocol is to wash privacy curtains approximately every three months unless there is obvious staining, in which case they would be replaced sooner.
The first hospital group had an on premise laundry (OPL) service and paid $2.50 - $3.00 per curtain per wash. The other hospital, also with an OPL service, paid $4.40 per curtain per wash.
To dry clean a reusable curtain costs approximately $9.50 per curtain and washing according to Australian Standard 4146 costs $7.92 per curtain.
Disposal costs
It is often overlooked that disposable privacy curtains incur disposal costs. In general, disposable curtains are considered general waste unless there is visible blood staining, in which case they become clinical waste.
One hospital paid $0.33 - $0.43 per/kg for general waste and $0.72 per/kg for clinical waste. The other hospital couldn’t give specific numbers, but claimed they paid five times more per kilo for disposal of clinical waste as compared to general waste.
As a comparison, the 2002 Auditor General’s report on NSW Hospitals Waste Disposal found that Concord Hospital’s costs were $0.109 per/kg for general waste and $0.93 per/kg for clinical waste.
For the sake of comparison, the average of both sets of figures works out at $0.30 per/ kg for general waste and $0.80 per/kg for clinical waste.
Conclusion
The relative efficiency of each curtain type depends largely on the IC policies of individual hospitals, including policies relating to hang time, acceptable levels of soiling and washing standards.
These variables as well as the unpredictability of a curtain being stained before it’s due for replacement (resulting in higher washing and/or disposal fees) make it almost impossible to produce exact figures that apply across the board.
All groups surveyed felt that disposable privacy curtains were more effective for infection control, mostly based on information provided by their disposable curtain suppliers. Therefore the general feeling is that hospitals are slowly moving towards complete adoption of disposable privacy curtains in all areas.
On a more subjective level, it’s fair to say that disposable privacy curtains are to ward interiors what styrofoam cups are to restaurants, easy to dispose of but in some cases more expensive and always less attractive.
Research suggests that far from only being an aesthetic concern, hospitals that are designed and furnished in a less “clinical” way have better patient health outcomes and recovery times^{(1, 2)}.
Therefore reusable curtains play an important part in the healing process, something that cannot be claimed of disposable privacy curtains.
Finally, when considering pricing it becomes obvious that the determining factor in choosing the most effective product directly relates to the frequency of washing reusable curtains and/ or the rate at which disposable curtains are replaced.
The attached table shows that as soon as a disposable privacy curtain is changed four times a year, it loses its financial benefit (when compared to a reusable curtain that is washed four times per year for a five year period).
Reusable vs disposable privacy curtains: A lifetime cost comparison

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References
(1) Commission for Architecture and the Built Environment, (2009). Future health: Sustainable placed for health and wellbeing, London: CABE.
(2) Veitch, J.A., (2008). Investigating and influencing how buildings affect health; Interdiciplinary endeavours.

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