June 1, 2011

We are continuing our discussion of an interview with a disease prevention specialist who voiced her concerns about the increasing incidence of Clostridium difficile infection (CDI). This concern is confirmed by the Office for Oregon Health Policy and Research. In a recent OHPR report that detailed the agency’s health-associated infections priorities, C. diff was flagged frequently as a nursing home or hospital infectionthat deserves better data collection and more study.

In her interview, the prevention specialist discussed how quickly the bacteria spread and how long the spores can survive. For CDI, the best defense is truly a strong offense. Health care facilities need to prevent the introduction of the bacteria into their environments, but they also must contain an infection once it’s discovered.

The first step in contamination control, then, is to educate everyone on staff — regardless of their levels of patient contact — of the dangers of CDI and the policies and procedures that address the infection. Caregivers must be trained in recognizing the symptoms of C. diff, and labs should be instructed to process tests quickly. Early detection is, obviously, key to early control of further contamination.

When a case is confirmed (or highly probable), the patient must be isolated immediately. If a private room is not an option, said the expert, facilities should consider rooming CDI patients together.

All surfaces must be cleaned and disinfected according to protocol. And, anyone who has contact with the patient, including visitors, must wear a gown, gloves and a mask — full personal protection that will prevent the inadvertent spread of the bacteria.

The policies and procedures cannot be limited to one ward or only one unit in the facility. The entire facility must adopt them wholesale, with departments and individual staff members assigned specific tasks. With experience, staff will be able to revise the procedures to make them more effective.

It is an enormous undertaking. But CDI is enormously difficult to fight.

Source: Infection Control Today, “Best practices for addressing CDI,” 06/09/2011


Categories: Blog