Infection Prevention Podcast - Ania Swann

Summary

In the 'Inside Northumbria' podcast, clinical educator Rachel and specialist infection prevention nurse Anya discuss Clostridioides difficile (C. diff), a bacterium causing severe diarrhea and colitis. They cover its environmental resilience, transmission through ingestion, and infection control measures, emphasizing hand hygiene with soap and water due to C. diff's resistance to alcohol-based sanitizers. The podcast also addresses patient isolation, the importance of a traffic light system for diagnosis, and the potential complications of C. diff, including pseudomembranous colitis and toxic megacolon, highlighting the need for vigilance in patient care.

Takeaways

• 🌐 'C diff' stands for Clostridioides difficile, a bacterium that can cause severe intestinal problems and is resistant to alcohol-based sanitizers.
• 🌱 C. difficile spores can survive in the environment for months, potentially found on surfaces and in soil, posing a risk for infection.
• 🤲 Hand hygiene is crucial in preventing the spread of C. difficile, with liquid soap and water being the preferred method over hand sanitizers.
• 🏥 Staff members should isolate patients with new-onset diarrhea in a timely manner and use personal protective equipment to prevent infection spread.
• 🔍 If a patient develops diarrhea, the medical staff should review their medication and conditions that might contribute to the symptoms.
• 📝 The 'traffic light system' is used to assess patients for C. difficile infection, considering both bowel symptoms and other contributing factors.
• 🚨 Offensive-smelling stools can be a sign of C. difficile infection, prompting the need to contact the infection control team for further action.
• 🧪 A C. diff pathway document outlines the responsibilities of staff in managing and documenting C. difficile cases, with an emphasis on environmental cleaning.
• 📉 The number of C. difficile cases has seen a decrease due to preventative measures but has not been completely eradicated.
• 💔 Complications of C. difficile can include colitis, pseudomembranous colitis, and in severe cases, bowel perforation which can be fatal.
• 📈 There is a current increase in C. difficile cases across the trust and the UK, indicating a broader trend in healthcare organizations.

Q & A

What is the full name of the bacterium commonly known as C diff?

The full name of the bacterium commonly known as C diff is Clostridioides difficile.

How long can C diff spores survive in the environment?

C diff spores can survive in the environment for a number of months and still be active.

How is C diff typically spread?

C diff is typically spread through ingestion, which can occur via contact with a contaminated environment or with hands that have come into contact with contaminated surfaces.

What is the significance of hand hygiene in preventing the spread of C diff?

Hand hygiene is critical in preventing the spread of C diff because the bacterium's spores are resistant to alcohol-based hand sanitizers. Washing hands with liquid soap and water is the recommended method.

What should staff do if they identify a patient with new diarrhea?

Staff should ensure the patient is isolated in a side room in a timely manner, use personal protective equipment, and practice proper hand hygiene.

What is a telltale sign of C diff infection besides diarrhea?

A telltale sign of C diff infection, besides diarrhea, is the production of stools with a distinctive, offensive, and sickly sweet smell.

What is the traffic light system and how does it relate to C diff?

The traffic light system is a method within the organization that prompts staff to assess patients holistically, considering factors like medications and conditions that might contribute to symptoms like diarrhea, which could be indicative of C diff.

What documentation should be completed when a C diff result is obtained?

A C diff pathway, which is a paper copy document outlining the responsibilities of various staff members, should be completed. It includes daily reviews of the patient's condition and monitoring of fluid balance and inflammatory markers.

How often should environmental cleaning be performed for a patient with C diff?

Environmental cleaning should be encouraged at least twice, if not three times daily for a patient with C diff to minimize the bacterial load and spore count in the environment.

What are some potential complications of C diff infection?

Potential complications of C diff infection include severe colitis, characterized by abdominal pain and distension, and in severe cases, toxic megacolon and bowel perforation, which can be fatal.

Is the increase in C diff cases seen in the trust mirrored across the UK and other organizations?

Yes, the increase in C diff cases is not only seen in the trust but also across the UK and other organizations, as reported through mandatory case reporting and national statistics.