Take a hands off approach
October 1st 2007 The Healthcare Commission's investigation of outbreaks of Clostridium difficile at
Maidstone and Tunbridge Wells NHS Trust demonstrates the need to ensure there are
enough nursing and cleaning resources to implement the necessary measures to
contain transmission of the bacterium. Dart Valley says no-touch taps can help
Clostridium difficile has become another high profile HCAI
causing concern.The report produced by the Healthcare
Commission Investigating outbreaks of Clostridium difficile at
Maidstone and Tunbridge Wells NHS Trust is quite disturbing. It clearly
demonstrates the need to ensure there are enough nursing and
cleaning resources to implement the necessary measures to contain
transmission of the bacterium.
Many Trusts currently do not have the optimum facilities, finances,
staffing levels, and cleaning resources required to completely
eradicate transmissions.Nevertheless, it should be the target.
Figures published by the Health Protection Agency earlier this year
show there were 42,625 cases of Clostridium difficile infection in
patients aged 65 years and above in England in the first three
quarters of 2006.This represents an increase of 5.5 per cent over the
same period in 2005, when there were 40,390 cases reported.While
this is a smaller increase than seen previously, rates of infection
remain high across England, particularly in small acute trusts, and the
results show clearly the scope for improvement.With the emergence
of the 027 strain (which is
significantly more toxic than other
strains and is resistant to many
antibiotics), there remains great
cause for concern and serious
measures are required to combat
its spread.
It has been widely publicised
that if C. difficile is in the gut,
antibiotics can disrupt normal
bowel flora and promote C. difficile
overgrowth.This is an issue for
medical experts to deal with, but
containing and reducing the
spread of the bacterium requires
strict infection control practices to
be implemented by all care
workers.
An article by Cleveland Clinic
Journal of Medicine published on the CDC website provides some
useful guidance1: "Transmission of C. difficile occurs primarily in
health care facilities via the fecal-oral route following transient
contamination of the hands of health care workers and patients;
contamination of the patient care environment also plays an
important role."
"The most effective means of decreasing horizontal spread of
C. difficile has been a combination of vigilant hand hygiene and use
of isolation precautions."
"Alcohol is not effective in killing C. difficile spores.Therefore if a
hospital is experiencing an outbreak, it is prudent for health care
workers to wash their hands exclusively with soap and water when
caring for patients with known CDAD."
The spores can survive in the environment for long periods. If
cleaning is not effective healthcare workers can easily transmit the
bacterium from surfaces to an uninfected patient. Not all cleaning
disinfectants kill the spores, the reference article that follows
recommends using bleach.
If the hospital does not have sufficient isolation facilities then
patients should be cohorted.
Hand hygiene is acknowledged as the single most important
infection control measure yet compliance still generally remains
below 50 per cent.The number and locations of clinical handwash
basins is a very important
factor in the quest to improve
compliance in hospitals.C.
difficile emphasises the
importance of hand washing
with liquid soap and water
which remains a critical part
of hand hygiene.
Hand hygiene protocols
have always included washing
hands with liquid soap and
water following certain
activities or if the hands are
visibly soiled. Renewed
awareness has encouraged
many hospitals to retro-fit
additional hand wash
facilities.
Tap handles can be a source of transmission and even if healthcare
workers are sufficiently dexterous to use arms, it is more hygienic not
to touch a contaminated surface with arms or hands.
No-touch taps have many advantages over lever taps and, apart
from avoiding the risk of contamination, the ease of use has also been
shown to increase hand washing compliance.
For further info just call the number below or enquire online.
1 www.cdc.gov/ncidod/dhqp/pdf/infDis/Cdiff_CCJM02_06.pdf More articles from Dart Valley Systems Ltd: | 
