Patients, Visitors and Clinicians Can Stop the Spread of C. Diff on Cancer Units

Clostridioides difficile – commonly referred to as C. diff – is a serious infection that can negatively impact outcomes in patients with cancer. So, it is crucial that patients and their loved ones do their part to decrease the spread, according to Karen Wohlgezogen, a clinical nurse manager at the City of Hope National Medical Center.

“C. diff is a spore-forming [bacterium] that is very resilient, and difficult to kill,” Wohlgezogen said in a recent presentation about preventing the spread. “It causes life-threatening diarrhea and colitis.”

After seeing a spike in C. diff rates at their hospital a few years ago, Wohlgezogen and her team analyzed the problem and then created an intervention plan to stop the spread.

Finding the Root of the Issue

The initial analysis showed some potential reasons why more people were being infected with C. diff than usual. First, the researchers found that many people visiting individuals with C. diff in the hospital did not wash their hands as they were leaving patient rooms.

Additionally, C. diff was spreading in hospital rooms that were next to each other, which likely was a result of staff spreading the infection. When given surveys on C. diff protocols, some employees were not able to correctly answer questions regarding the cleaning of shared equipment.

“Anytime you’re cleaning anything having to do with C. diff, you definitely have to use bleach, so it’ll kill the spores. Alcohol gel and alcohol wipes don’t do it,” Wohlgezogen said. “But we had complaints from staff, patients, and families about using bleach. They didn’t like the strong smell, it seemed to stain the clothes of the staff using it.”

Decreasing Infection Rates

After they better understood why C. diff was spreading, Wohlgezogen was able to institute a plan to decrease rates, starting with patient and staff education. To mitigate excess travel of family members around the hospital, and ensure that proper cleaning policies were in place, nurses began to get patients and their visitors things that they may want or need, such as coffee or snacks.

On the patient side, clinicians emphasized the importance of daily bathing for patients with C. diff, to decrease the amount of bacteria that was on their body.

Staff made changes, too. They started using single-use items for medical equipment like commodes. “Once we did the bedside commode buckets as a single use, we definitely saw a decrease [in C. diff],” Wohlgezogen said.

The team also decided to keep vital sign machines and computers on wheels in isolated patients’ rooms, when possible, so that they would not have to be rolled from one room to another.

“Our recommendation is to maintain a high focus on [C. diff] infection prevention, and that the education just continues with the nursing [and medical] staff, patient families, and all the people who touch the patients,” Wohlgezogen said.

This article was originally published on OncLive as, “Prevent the Spread of C. Diff on Oncology Units.”