C. difficile cases at the Niagara Health System

Greater Niagara General Site
There are fourteen cases (no change). There are four hospital-associated cases (up one – includes reclassification) and ten community/other cases (down two – including one reclassification, up one).

St. Catharines General Site
There are eight cases (up three). There is one hospital-associated case (no change) and seven community/other case (up three).

Douglas Memorial Site
There are two cases (up one). There is one hospital-associated case (no change) and one community/other case (up one).

Niagara-on-the-Lake Site
There is one case (no change). There is one hospital-associated case (no change) and zero community/other cases (no change).

Port Colborne Site
There are two cases (up one). There are zero hospital-associated cases (no change) and two community/other cases (up one).

Welland Site
There are twelve cases (up one). There are three hospital-associated cases (no change) and nine community/other cases (up one).

* The Community/other category, non-hospital associated cases includes community, relapses, reoccurrences and colonized (previous history of C. difficile) cases.

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What is C. difficile?

Clostridium difficile (C. difficile) causes diarrhea and is one of the most common infections in hospitals and long-term care facilities. People most at risk after exposure are typically of advanced age, and with underlying illnesses such as inflammatory bowel disease or immunodeficiency, who are also taking antibiotics. Antibiotics kill off the “good bacteria” in the bowel and allow the C. difficile to flourish and cause illness. MORE ABOUT C. DIFFICILE »

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What Infection Control Practices are used?

We must continue to be vigilant with our infection prevention and control practices. We will all work to our fullest capacity to maintain a quality and safe patient environment.

We have taken many steps to enhance our practices based on the recommendations of the provincial Infection Control Resource Team. This team is available to hospitals to provide additional advice and support on outbreaks and control measures, and we greatly appreciate their assistance to ensure we were doing everything we could to bring an end to the outbreaks.

Some of the recommendations from the ICRT that were immediately implemented and remain in effect today included more intensive cleaning and enhanced communications to the frontline regarding hand hygiene and the use of personal protective equipment.

There are many “new normal” infection prevention and control practices in our hospitals. These new normal practices have been in place for several months now, and it is our commitment to embed these practices into our daily routine on an ongoing basis.

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The ‘new normal’

Examples of what the “new normal” looks like in terms of regular infection prevention and control practices:

• We have a new trigger system that will enable us to quickly respond to suspected C. difficile cases with enhanced cleaning and patient isolation.
• Our cleaning practices related to C. difficile and other hospital acquired infections have been enhanced.
• There will continue to be regular hand hygiene audits of staff and physicians to ensure 100 per cent compliance with best practice. This means staff and physicians must clean their hands before and after every contact with a patient and the patient environment, as well as before an aseptic procedure and after body fluid exposure risk.
• There will be ongoing screening of ER patients, inpatients and outpatients, including those coming to clinics and for tests.
• We will continue to cover all equipment that has been cleaned with plastic covering. This will ensure staff use only equipment that has been thoroughly cleaned according to infection prevention and control standards.
• Our staff will continue to have daily huddles at the beginning of each shift to share any questions or concerns.
• Food and drink will be restricted in patient rooms unless it is for the patients.
• We have moved to genetic testing (PCR) for C. difficile; more accurate, detecting more cases.
• We have stopped the practice of cohorting patients.
• There are limits on movement of equipment between units.
• Increases in housekeeping resources in place during the outbreaks will be maintained.
• We have extended the use of sporicidal agents across the hospital, vs. use solely in patient bathrooms.
• Terminal clean – more intensive cleaning – has occurred across facilities; units with recurrence have been terminally cleaned again.
• Enhanced housekeeping audits and checklist.
• Antibiotic stewardship enhancements ongoing across our sites.
• Enhanced transparency and clear communication approach.
• Clear signage, hand hygiene stations, and overhead voice message concerning the outbreaks and need for hand hygiene.

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What the Public can do

Strict adherence to rigorous hand hygiene standards is a priority. Hand hygiene is critical for staff, patients and for visitors upon entering and exiting the hospital, and is of critical importance on entering and exiting patient rooms, and upon touching any equipment or surfaces in patient rooms. All staff and/or visitors to affected patients must wear proper personal protective equipment per our regular practice.

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Visiting hours

Restricted visiting hours – 4 to 8 p.m. daily  –  are in place at the Greater Niagara General Site, Unit D.  This is a temporary measure to reduce the amount of traffic in patient areas and allow for enhanced cleaning. While restricted visiting hours are in place, visitors must be 13 years of age or older except for compassionate reasons.

At the NHS, we always consider the patient’s and family’s needs when it comes to visiting hours. Compassionate reasons or other reasons to extend visiting hours will be considered.

The long-standing visiting policy restricts the number of visitors to two per patient at one time, and that requirement will be enforced. Please only visit one patient room during any outing to the hospital during the outbreak. The best way everyone can help is through good hand hygiene and the expectation is that everyone adheres to our practices, cleaning their hands at every opportunity, especially when entering and leaving our facilities, before entering and leaving patient rooms and before and after touching any surfaces or equipment in the patient rooms. Visitors should not visit the hospital if they are feeling ill. Visitors may be required to wear protective equipment, which includes gowns and gloves, when visiting patients.

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Restrictions on pets and plants

The public is asked not to bring pets or plants to the hospital.

This restriction does not include service and therapy animals. The visitation of pets belonging to patients will be reviewed in by our Infection Prevention and Control department on an individual basis in compassionate circumstances.

Flowers and plants in the hospital are generally discouraged as per the provincial Infection Control and Resource Team recommendations. Flowers and plants are strictly prohibited in critical care areas such as the Intensive Care Unit, the Complex Care Unit, and the Neonatal Intensive Care Unit.

Animals and plants are sources that can transmit bacteria, and we hope people will understand that this measure is important to prevent the spread of infection.

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Restrictions on food and drinks

Visitors are asked not to bring food or drink into the hospital to eat while visiting patients. The only people who should be eating or drinking in the patient rooms are the patients. If you do bring in food for your loved ones, please check in with the nursing station as is the usual practice because they may be on a special diet.

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Cleanliness

If you are in the hospital and see any area that does not meet cleanliness standards, please call 905-378-4647, ext. 33500 immediately to ensure action is taken to rectify the situation. If you have any concerns or questions, please email us at scghospitality@niagarahealth.on.ca

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