Effective Hospital Cleaning Protocols For C. Diff Eradication

Clostridium difficile, often referred to as C. diff, is a dangerous bacterium that can cause inflammation of the colon and life-threatening symptoms. C. diff is highly contagious and prevalent in healthcare settings, and can survive on inanimate objects for up to five months. Proper cleaning and disinfection procedures are crucial to prevent its spread. Hospitals employ various strategies, including the use of EPA-approved disinfectants, bleach solutions, and dedicated patient-care equipment, to combat C. diff and protect patients and staff.

Hand hygiene

In healthcare facilities, hand hygiene practices should be adhered to, especially when handling patients with C. diff infections. This includes washing hands with soap and water after removing gloves and before and after touching any surfaces or items in the patient's immediate environment. It is also important to wash hands after using the restroom and before handling food to prevent the spread of C. diff spores.

Additionally, healthcare personnel should pay close attention to their hand hygiene practices when handling items that have come into contact with a patient's skin. C. diff germs can reside on the skin, and individuals who touch an infected person's skin can inadvertently spread the bacteria if they do not practise proper hand hygiene. This includes washing hands with soap and water before and after touching a patient, as well as after removing gloves.

Furthermore, it is recommended to implement daily patient bathing or showering with soap and water to reduce the presence of C. diff on the skin and decrease the likelihood of transmission. This is especially important for patients with confirmed C. diff infections to minimise the risk of spreading the bacteria to others.

Overall, hand hygiene plays a vital role in preventing the spread of C. diff in healthcare settings. By following recommended handwashing practices and using soap and water effectively, healthcare professionals, patients, and visitors can significantly reduce the transmission of this dangerous bacterium.

Cleaning products

Clostridium difficile, or C. diff, is a dangerous bacterium that can cause inflammation of the colon and life-threatening symptoms. It is highly contagious and can survive on inanimate objects for up to five months. C. diff is extremely prevalent in healthcare settings due to the presence of human faeces, which is a common biohazard.

To prevent the spread of C. diff, hospitals employ a variety of cleaning products and strategies. Here are some of the products and strategies used:

Disinfectants

An EPA-approved disinfectant (EPA: LIST K: EPA’s Registered Antimicrobial Products Effective against Clostridium difficile Spores) is recommended for disinfecting surfaces in hospitals. This type of disinfectant is specifically designed to be effective against C. difficile spores. Alternatively, a 1:10 dilution of 5.25% sodium hypochlorite (household bleach) and water, freshly mixed daily, can be used. Bleach products are crucial for combating the spread of C. diff spores on surfaces. However, it is important to follow manufacturer guidelines when using bleach to avoid corrosion on medical equipment.

Wipes

In addition to sprays and dilutions, disinfectant wipes are also used in hospitals. Bleach wipes, specifically, are used for daily and discharge cleaning of C. diff rooms. Hydrogen peroxide wipes have also been proven to be effective against C. diff, especially in bathroom settings.

Laundry detergents and additives

Hospitals must follow the manufacturer's instructions for all materials involved in laundry processing, including washing machines, dryers, laundry detergents, rinse aids, and other additives. This ensures that laundry items, such as clothing and linens, are hygienically clean and free from C. diff spores.

Hand hygiene

While not specifically a cleaning product, hand hygiene is crucial in preventing the spread of C. diff. Soap and water are significantly more effective than alcohol-based hand sanitizers in reducing C. diff germs on the skin.

Sporicidal agents

In acute care facilities, C. difficile sporicidal agents (EPA List K agents) are used for daily and terminal cleaning in all rooms on affected units. These agents help reduce the risk of transmission by targeting the spores produced by C. diff.

Overall, hospitals utilize a combination of disinfectants, wipes, proper laundry procedures, hand hygiene, and sporicidal agents to combat the spread of C. diff and ensure a safe environment for patients and healthcare professionals.

Laundry

Clostridioides (Clostridium) difficile, or C. diff, is a highly contagious bacterial infection that can spread through contact with contaminated surfaces and items. As such, it is crucial to implement strict cleaning and disinfection protocols in hospitals and other long-term care facilities to prevent the transmission of C. diff and protect vulnerable patients.

Modern laundry detergents are highly effective in removing soil and reducing microbial presence. Hospitals should select detergents specifically designated for laundry processing, as advised by the CMS in collaboration with the CDC. It is important to follow the manufacturer's instructions for detergent usage, including the recommended quantity and any specific application guidelines.

Water Temperatures and Chlorine Bleach:

Hospitals should establish comprehensive policies and procedures for laundry handling, including staff training. These policies should encompass the selection of appropriate detergents, additives, and processing methods, considering factors such as fabric type and individual patient needs (e.g., allergies). By ensuring that staff are properly trained in handling linens and laundry, hospitals can minimize the risk of C. diff transmission through contaminated laundry.

Hand Hygiene:

Proper hand hygiene is crucial before and after handling laundry, especially when dealing with items soiled by body fluids or used by patients infected with C. diff. Gloves should be worn during the handling of soiled laundry, and hands should always be washed with soap and water afterward to prevent the spread of C. diff through hand contact.

By adhering to these stringent laundry practices, hospitals can effectively manage the risk of C. diff transmission and protect the health and safety of patients, staff, and visitors.

Isolation

The challenge with C. diff is that it can be spread by asymptomatic carriers, making it difficult to implement timely isolation measures. Asymptomatic patients at high risk for C. diff should be evaluated and tested, and those who test positive should be isolated, even if they are not displaying symptoms.

In addition to isolating patients, hospitals should also dedicate specific healthcare personnel to the care of patients with C. diff to minimize the risk of transmission to others. This dedicated staff model helps contain the spread of the bacterium by limiting the number of individuals interacting with infected patients.

To further enhance isolation protocols, hospitals can utilize single-patient rooms or cohort patients with C. diff on a single ward or unit. This spatial arrangement reduces the likelihood of cross-contamination between infected and non-infected patients, as it limits their interaction and shared spaces.

Overall, isolation plays a crucial role in preventing the spread of C. diff within healthcare facilities. By isolating infected patients, evaluating and testing high-risk asymptomatic individuals, dedicating specific healthcare personnel, and utilizing strategic ward designs, hospitals can effectively curb the transmission of this challenging bacterium.

Equipment

Hospitals use a variety of equipment to clean and disinfect surfaces and medical equipment in order to prevent the spread of C. diff.

One crucial piece of equipment is the disinfectant solution. An EPA-approved disinfectant or a diluted solution of sodium hypochlorite (household bleach) and water is recommended for disinfecting surfaces and equipment. Hospitals may also use hydrogen peroxide-based solutions, such as Sani-HyPerCide, which are effective against C. difficile.

In addition to disinfectant solutions, hospitals use a range of applicators and tools for effective cleaning. This includes lightweight and sturdy hardware, such as the ZeroGravity mopping system offered by Contec Inc., which improves compliance with stricter cleaning guidelines. Disposable wipes, such as the Disinfectant 1 wipe by Ecolab, are also used to clean surfaces and equipment. These wipes are saturated with a multipurpose cleaner and disinfectant, and they do not require the use of personal protective equipment (PPE).

For laundry processing, hospitals use washing machines, dryers, laundry detergents, rinse aids, and other additives. Hospitals also utilize electrostatic devices, such as the CloroxPro system, which can be used with Sporicidin Disinfectant Solution to kill C. difficile.

To ensure the safety of cleaning staff, personal protective equipment (PPE) is also crucial. This may include gloves, masks, and other protective gear to prevent exposure to disinfectants and contaminated surfaces.

Overall, hospitals employ a variety of equipment, solutions, and tools to effectively clean and disinfect surfaces, medical equipment, and laundry to prevent the spread of C. diff and protect the health and safety of patients and staff.

Frequently asked questions