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Hand-washing key to preventing spread of C. difficile

Posted Dec 8th, 2008

Niagara Falls, ON: Frequent hand-washing is a crucial measure in clearing up an outbreak of Clostridium difficile (C. difficile) declared at Greater Niagara General Site's Unit C Medical Inpatient Unit on Friday, December 5, 2008.

The Niagara Health System (NHS) is asking for the public's support and co-operation as it moves to strictly enforce the visiting hours policy and enhance infection prevention and control measures.

"We have strict isolation procedures and outbreak precautions that we require all staff, physicians, patients and their visitors to follow whenever we declare an outbreak, and we are being extremely vigilant with this C. difficile outbreak," says Frank Demizio, VP Patient Services.

Patients have been cohorted together on Unit C to allow staff to follow the strict precautions efficiently and to prevent the spread of infection to other clinical areas. There are currently six confirmed cases of C. difficile and one suspected case of C. difficile on Unit C.

Under provincial legislation, a health-care facility must declare an outbreak when there are six or more new hospital-acquired cases of C. difficile in a specific unit over a 30-day period. The NHS will continue to work with the Niagara Public Health Department and the Ministry of Health and Long-Term Care to determine when the outbreak can be declared over.

C. difficile is a bacteria found in the stool. The usual symptoms are mild but can be severe. Main symptoms are watery diarrhea, fever, abdominal pain / tenderness. Blood may or may not be present in the stools. In some cases, there may not be diarrhea. In severe cases, surgery may be needed and in extreme cases C. difficile may cause death. While C. difficile can be acquired in hospital, it can also be acquired in the community.

Healthy people are usually not at risk of serious infection. However, these organisms can cause harm to those who are seriously ill or have a poor immune system. These organisms can be treated, but preventive action helps all patients and staff.

"It is absolutely necessary that everyone follows the provincial guidelines to prevent and control the spread of organisms to our patients," Demizio says. "In addition to gowning and gloving, the importance of hand washing cannot be overstated. It is the single most important way to prevent infections. As well, please don't visit a patient in hospital at any time if you don't feel well. You could easily pass on your infection to others."

Visitors are restricted to two per patient at one time. Visiting hours are from 2 p.m. to 8 p.m. only. Patients currently in isolation have instructions posted on or by their room door, and all visitors will be required to put on gowns and gloves, and to follow the instructions for thorough hand washing. Upon entering the hospital, all visitors should use the alcohol hand-wash, which is also located throughout the hospital.

"Managing infectious outbreaks is a common challenge for hospitals everywhere," says Mr. Demizio. "These organisms can spread easily in the community and in hospital if appropriate steps are not taken. People can unknowingly pass the germs from one person to another, or they can pick up these germs from environmental surfaces like door handles. The NHS needs active participation from the community in order to combat these organisms."

The NHS screens patients regularly for the organisms as part of its Infection Prevention and Control measures. These screening measures are being heightened at this time to ensure all patients are identified as soon as possible.

Other Infection Prevention and Control measures include intensive and more frequent cleaning of patient rooms and surfaces on outbreak floors, and greater precautions by health-care workers through the use of gloves, gowns and other protective equipment.

For more information on C. difficile and other infections, such as VRE and MRSA, go to and follow the links after clicking on Quality and Safety.

If you come to the hospital, please follow these guidelines and precautions:

  • Read all signs at entrances, elevators and in patient units that inform visitors of where outbreaks are and what precautions are in place.
  • Always wash your hands thoroughly with soap and water for at least 15 seconds and limit the amount of jewelry on your hands (jewelry prevents thorough cleaning).
  • Always wear appropriate personal protective equipment identified and supplied by the hospital before entering the patient room. In the case of C. difficile, gloves and gowns are required to be worn by everyone in contact with the patient.
  • Do not use any patient washrooms or sinks.
  • Be extremely vigilant to ensure everyone is following the guidelines and procedures. If you notice the guidelines and procedures aren't been followed by others, don't hesitate to inform the Unit Nurse or Nurse Manager so appropriate action can be taken.
  • If you have any questions, always contact the Unit Nurse or Nurse Manager.

Niagara Health System