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February 27, 2009
Patient Information
PATIENT INFORMATION
CLOSTRIDIUM DIFFICILE (C-Diff)
Carleton Place and District Memorial Hospital takes your care and safety very seriously. On a monthly basis, beginning in September 2008, we will be reporting our C. Diff infection rates on our website.
If you have any questions about the information below or about our hospital’s infection prevention and control program, please contact the Assistant Executive Director of Patient Services at 613-253-3827
Measuring Clostridium difficile (C. difficile) rates
Carleton Place & District Memorial Hospital posts its infection rates online on a monthly basis. On this website, you can find information about hospital-acquired infection rates for C. difficile.
What are hospital-acquired infections?
Sometimes when patients are admitted to the hospital, they can get infections. These are called hospital-acquired infections. In the case of C. difficile, this may mean that symptoms began 72 hours after admission to the hospital; or that the infection was present at the time of admission but was related to a previous admission to that hospital within the last four weeks.
What is C. difficile?
C. difficile (Clostridium difficile) is a bacteria. C. difficile can be part of the normal bacteria in the large intestine and is one of the many bacteria that can be found in stool (a bowel movement). A C. difficile infection occurs when other good bacteria in the bowel are eliminated or decreased allowing the C. difficile bacteria to grow and produce toxin. The toxin produced can damage the bowel and cause diarrhea. C. difficile is one example of a hospital-acquired infection and is one of the most common infections found in hospitals and long-term care facilities. C. difficile has been a known cause of health care associated diarrhea for about 30 years.
Who is at risk for C. difficile?
Healthy people are not usually susceptible to C. difficile. Seniors, and people who have other illnesses or conditions being treated with antibiotics and certain other stomach medications, are at greater risk of an infection from C. difficile.
What are the symptoms of C. difficile?
The usual symptoms are mild but can be severe. Main symptoms are watery diarrhea, fever, abdominal pain /tenderness. In some cases there may not be diarrhea. Blood may or may not be present in the stools.
How do you get C. difficile?
C. difficile is the most common cause of hospital associated infectious diarrhea. Since it can be part of the normal bacteria that live in the large intestine, taking antibiotics can change the normal balance of bacteria in your large intestine making it easier for C. difficile to grow and cause an infection. Old age and the presence of other serious illnesses may increase the risk of C. difficile disease.
How does C. difficile spread?
When a person has C. difficile, the germs in the stool can soil surfaces such as toilets, handles, bedpans, or commode chairs. When touching these items, your hands can become soiled. If you then touch your mouth, you can swallow the germ. Your soiled hands can spread germs that can survive for a long time on other surfaces if not properly cleaned.
The spread of C. difficile occurs due to inadequate hand hygiene and environmental
cleaning; therefore, proper control is achieved through consistent hand hygiene and
thorough cleaning of the patient environment. Good hand hygiene i.e. washing hands thoroughly and often is the single-most effective way to prevent the spread of infectious diseases like C. difficile.
Does Carleton Place & District Memorial Hospital track C. difficile cases?
At Carleton Place & District Memorial Hospital we are committed to promoting hand hygiene for patient care. We provide access to alcohol-based hand products as well as soap and water throughout the facility for staff, patients and visitors to use. We have a process to audit the hand hygiene of staff members and provide feedback. We follow the advice and practices in the Ontario “Just Clean Your Hands” campaign to help us provide best practices in hand hygiene in caring for our patients.
How is C. difficile diagnosed?
C. difficile is usually diagnosed by sending a specimen of diarrhea to the laboratory where it is tested for the presence of the C. difficile toxin.
How is C. difficile treated?
Treatment depends on how sick you are. People with mild symptoms may not need
treatment. For more severe disease, antibiotics are required.
What precautions are used to prevent the spread of C. difficile in the hospital?
If you are in the hospital and have C. difficile diarrhea, you will be put on precautions until you are free from diarrhea for at least two days. Your activities outside the room may be restricted. All health care staff who enters your room will wear a gown and gloves. Everyone MUST clean their hands when leaving your room.
How does Carleton Place & District Memorial Hospital control the spread of C. difficile?
In order to prevent the spread of C. difficile, we engage our housekeeping team to ensure that they are following the best practices for cleaning in situations where patients are identified with C. difficile. As well, we are strongly encouraging our staff to enhance their hand hygiene practices. We ensure that patients who are suspected or proven to have C. difficile receive appropriate treatment as soon as possible. Once diarrhea has stopped in a patient with C. difficile, there is a much lower risk of contamination that might cause further cases.
Does Carleton Place & District Memorial Hospital track C. difficile cases?
Looking closely at the C difficile cases is an important step in making sure you are safe. This is called surveillance, and it allows us to know whether there is a problem in the hospital and to understand how big the problem is. We track all C. difficile cases in our hospital, and as soon as any case is identified, we bring in the resources needed to stop the possibility that it might spread to others.
What is the hospital doing to improve patient safety?
We have a patient safety program in the hospital to make sure that all practices are at the highest level possible to keep you safe. This includes:
· ensuring that our housekeeping practices are in line with the best practices in healthcare
· following the “Just Clean Your Hands” program for excellence in hand hygiene
· conducting audits on various practices to verify that patient care is as safe as possible
· implementing programs such as “fall prevention”, “medication safety” and “safer Healthcare Now” initiatives.
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METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA)
What is MRSA?
Staphylococcus aureus is germ that lives on the skin and mucous membranes of healthy people. Occasionally S. Aureus can cause an infection. When S. Aureus developes resistance to certain antibiotics, it is called methicillin-resistant Staphylococcus aureus, or MRSA.
How is MRSA Spread?
MRSA is spread from one person to another by contact, usually on the hands of caregivers. MRSA can be present on the caregiver’s hands either from touching contaminated material excreted by the infected person or from touching articles contaminated by the skin of a person with MRSA, such as towels, sheets and wound dressings. MRSA can live on hands and objectives in the environment.
What Special Precautions are Required for MRSA?
It is important that special precautions are taken to stop MRSA from spreading to other patients in the hospital.
These precautions include:
- Single room accommodation (the door can remain open)
- A long-sleeved gown and gloves must be worn by everyone who care for you
- A sign may be placed on your door to remind others who enter your room about the special precautions
- The room and the equipment used in the room will be cleaned and disinfected regularly
- Everyone who leaves your room must clean their hands well
- You must clean your hands before you leave your room
What about family and visitors?
Your family and visitors should not assist other patients with their personal care as this may cause the germ to spread. They may be required to wear a long-sleeved gown and gloves while in your room. Before leaving your room, visitors must remove the gloves and gown and dispose of them in the garbage container and the linen hamper located in your room. Then they must clean their hands.
Good Hand Hygiene Practices
Remind all staff and visitors to practice good hand hygiene before and after they touch you. Ask your nurse of doctor to demonstrate proper hand hygiene techniques (15 seconds of soap and running water OR waterless alcohol hand rub until hands are dry).
You need to clean your hands:
- After using the bathroom
- After blowing your nose
- Before eating and drinking
- Before and after you touch your dressing or wounds
- When your hands are visibly dirty (soiled)
- Before you leave your room
What Will Happen At Home?
If you have MRSA at the time of discharge from hospital, the chance of spreading the germ to your family is small.
But, you should practice the following:
- Everyone who might help you with your personal hygiene or with going to the toilet should wash their hands after contact with you.
- Wash your hands before you make any food and before you eat. This practice should be followed by everyone in the household.
- Wash your hands well after using the toilet. Make sure others that use the bathroom wash their hands well afterwards.
- Clothing may be laundered in the same manner as the rest of the household laundry.
- No special cleaning of furniture or items (eg: dishes) in the home is required.
- Always tell your physician, paramedics, nurses or other care providers that you have MRSA. This helps prevent spread to others.
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VANCOMYCIN RESISTANT ENTEROCOCCUS (VRE)
What is VRE?
Enterococci are germs that live in the gastrointestinal tract (bowels) of most individuals and generally do not cause harm (this is termed “colonization”). Vancomycin-resistant enterococci (VRE) are strains of enterococci that are resistant to the antibiotic vancomycin. If a person has an infection caused by VRE, such as a urinary tract infection or blood infection, it may be more difficult to treat.
How Is VRE Spread?
VRE is spread from one person to another by contact, usually on the hands of caregivers. VRE can be present on the caregiver’s hands either from touching contaminated material excreted by an infected person or from touching articles soiled by feces. VRE can survive well on hands and can survive for weeks on inanimate objects such as toilet seats, taps, door handles, bedrails, furniture and bedpans. VRE is easy to kill with proper use of disinfectants and good hand hygiene.
What Special Precautions are Required for VRE?
It is important that special precautions are taken to stop VRE from spreading to other patients in the hospital.
These precautions include:
- Single room accommodation (the door can remain open)
- A long-sleeved gown and gloves must be worn by everyone who care for you
- A sign may be placed on your door to remind others who enter your room about the cpecial precautions
- The room and the equipment used in the room will be cleaned and disinfected regularly
- Everyone who leaves your room must clean their hands well
- You must clean your hands before you leave your room
What about family and visitors?
Your family and visitors should not assist other patients with their personal care as this may cause the germ to spread. They may be required to wear a long-sleeved gown and gloves while in your room. Before leaving your room, visitors must remove the gloves and gown and dispose of them in the garbage container and the linen hamper located in your room. Then they must clean their hands.
Good Hand Hygiene Practices
Remind all staff and visitors to practice good hand hygiene before and after they touch you. Ask your nurse or doctor to demonstrate proper hand hygiene techniques (15 seconds of soap and running water OR waterless alcohol hand rub until hands are dry).
You need to clean your hands:
· After using the bathroom
· After blowing your nose
· Before eating and drinking
· Before and after you touch your dressing or wounds
· When your hands are visibly dirty (soiled)
· Before you leave your room
What Will Happen At Home?
If you have VRE at the time of discharge from hospital, the chance of spreading the germ to your family is small.
But, you should practice the following:
-
Everyone who might help you with your personal hygiene or with going to the toilet should wash their hands after contact with you.
-
Wash your hands before you make any food and before you eat. This practice should be followed by everyone in the household.
-
Wash your hands well after using the toilet. Make sure others that use the bathroom wash their hands well afterwards.
-
Clothing may be laundered in the same manner as the rest of the household laundry.
-
No special cleaning of furniture or items (eg: dishes) in the home is required.
-
If you share a bathroom at home, clean the toilet and sink at least weekly with a germicidal cleanser.
-
Always tell your physician, paramedics, nurses or other care providers that you have VRE.
This helps prevent spread to others.
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