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Infection Prevention at Niagara Health System

Posted Jun 5th, 2011

Visitors are asked not to visit multiple patient rooms when they come to hospital. Please only visit one patient room during any outing to the hospital during the outbreak.

Update on C. difficile Outbreak at St. Catharines General Site

NIAGARA, Ontario – Two more patients at the St. Catharines General Site of the Niagara Health System (NHS) have tested positive for C. difficile, bringing the total to 19. NHS, in consultation with Niagara Region Public Health, declared the outbreak on Saturday, May 28, 2011. There are currently 15 cases of C. difficile admitted.

Medical staff will review the cases of two elderly patients who tested positive for C. difficile and died over the weekend. The reviews will determine what role C. difficile had or may have had in the patients’ deaths. Both of these patients had significant underlying health issues. It was determined that the first patient death was from other causes. Although C. difficile may have contributed to the patient’s death, it did not contribute as significantly as the patient’s pre-existing acute health issues.

Additional infection control measures that have been put in place at the St. Catharines Site include:

  • Charge Nurses on the inpatient units are documenting information about the patients who are positive with C. difficile as well as any patients suspected of being positive and awaiting test results.
  • The health system’s Medical Advisory Committee is establishing an antimicrobial stewardship subcommittee to review the types of antibiotics prescribed to patients. Some types of antibiotics can increase the likelihood of a C. difficile infection.
  • Housekeeping has increased staff and stepped up cleaning measures. Commodes and wheelchairs are being run through the cart washer. This is over and above the normal cleaning practices.
  • Purell handwipes are being distributed to patients on their food trays for them to clean their hands.
  • A questionnaire has been prepared for Emergency Department Triage Nurses to identify patients who may be potentially positive for C. difficile. The questionnaire includes questions about diarrhea, antibiotics and any history of recent hospital stays.
  • Security guards have been added to remind visitors of hand hygienerequirements and visitor limits.

The NHS team is continuing to work to its fullest capacity to reduce transmission of infectious diseases within the hospital. NHS thanks the public for their understanding and cooperation with control practices at this time.

BACKGROUND

What is C. difficile?

Clostridium difficile (C. diffficile) causes diarrhea and is one of the most common infections in hospital 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 antiobiotics. Antibiotics kill off the “good bacteria” in the bowel and allow the C. difficile to flourish and cause illness.

Are visitors allowed at St. Catharines General?

Visitors are asked not to visit multiple patient rooms when they come to hospital. Please only visit one patient room during any outing to the hospital during the outbreak. A maximum of two visitors are permitted per patient at one time duringvisiting hours. Visitors should clean their hands upon entering and leaving the hospital, and 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.

Is the Emergency Department open?

The Emergency Department is open, and all regular procedures continue to go ahead as scheduled.

QUOTES

“Our control measures will continue to be in place until Public Health is completely satisfied that the potential spread of C. difficile is eliminated. The teamwork that has been shown over the last week reflects the dedication of our healthcare team to the care and safety of our patients and families. We sincerely appreciate how an outbreak of this nature affects patients and their families.”

Frank Demizio, Vice President, Patient Services with responsibility for Infection Prevention & Control

Niagara Health System