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Transcript
Infection Prevention and Control – Clostridium Difficile Infection Strength of Evidence Level: 3 PURPOSE: To protect patients and agency staff from transmission of Clostridium difficile infection (CDI). CONSIDERATIONS: 1. CDI can range from uncomplicated diarrhea to sepsis and even death. 2. C. difficile is a spore forming bacteria. 3. C. difficile is shed in feces. Any surface, device or material that becomes contaminated with feces may serve as a reservoir for the C.difficile spore. 4. C. difficile transmission occurs via the fecal-oral route via the hands of healthcare workers who have touched a contaminated surface or item. 5. CDI is increasing in incidence and severity and may be becoming more difficult to treat. 6. If a patient has CDI, the clinician must assess for disease progression and follow infection control guidelines to prevent spread. 7. The infection can usually be treated with an appropriate course of antibiotics; including, metronidazole or vancomycin (usually reserved for severe cases or relapses) administered orally. 8. After treatment, repeat C. difficile testing is not recommended if the patient’s symptoms have resolved; the patient may remain colonized. 9. Use contact precautions for patients with known or suspected CDI. 10. Perform hand hygiene using soap and water if feasible (Alcohol based hand rubs are not as effective against spore-forming bacteria.). 11. C-difficile spores can be highly resistant to routine disinfectants and can survive on surfaces for many weeks or months. Bleach (1:10 dilution made fresh daily) is the appropriate disinfectant. EQUIPMENT: Gloves Antimicrobial soap Paper towels Gowns, aprons as indicated PROCEDURE: 1. Use contact precautions for all patients with known or suspected CDI. 2. Continue precautions until diarrhea has resolved for about 48 hours. AFTER CARE: 1. Instruct patient and caregivers on best way of cleaning and disinfecting their environmental surfaces and reusable devices like commodes, toilets, bathroom surfaces. 2. Instruct patients or caregivers on signs and symptoms of CDI and to observe for relapses. SECTION: 14.05 __RN__LPN/LVN__HHA REFERENCES: APIC Guide to Elimination of Clostridium difficile. (2003). HICPAC Guidelines for Environmental Infection Control in Health-Care Facilities. 52(No.RR-10).