Recommendations
Table 3. Summary of Recommendations to Prevent CDI (cont'd)
Essential Practices: should be adopted by all acute-care hospitals unless a clear and
compelling rationale for an alternative approach is present
9. Educate patients and their families about CDI as appropriate. (L)
a. Proper education about CDI transmission may help to alleviate patient and family
fears regarding being placed on contact precautions.
b. Include information about anticipated questions: general information about
CDI, colonization versus infection, the hospital's CDI prevention program, the
components of and rationale for contact precautions, the risk of transmission to
family and visitors while in the hospital and aer discharge, and importance of
hand hygiene by staff, patients, and visitors.
10. Measure compliance with CDC or WHO hand hygiene and contact precautions
recommendations. (L)
a. Patient-to-patient transmission of C. difficile is thought to occur primarily through
transient contamination of the hands of HCP with spores.
b. Using gloves when caring for patients with CDI or when touching surfaces in
their rooms, as well as hand hygiene practices in compliance with CDC or WHO
guidelines have been shown to be effective at preventing the transmission of C.
difficile.
Additional Approaches: can be considered for use in locations and/or hospital
patient populations when HAIs are not controlled after implementation of essential
practices
1. Intensify the assessment of compliance with process measures. (L)
a. Gowns and gloves should be worn by all HCP who enter the rooms of patients on
contact precautions.
b. Hand hygiene should be performed at least on entry and exit from patient rooms.
When hand washing is performed, determine whether proper technique is
being used. If hand hygiene compliance or technique are not adequate, conduct
interventions to improve hand hygiene compliance and technique.
c. Assess opportunities for improved antibiotic and/or diagnostic test utilization
with improved compliance with and/or using additional antibiotic or diagnostic
stewardship (see Essential Practices).
2. As the preferred method, perform hand hygiene with soap and water following care of
or interaction with the healthcare environment of a patient with CDI. (L)
a. When considering a CDI-specific hand hygiene measure, ensure adherence to
donning gloves and proper technique when doffing to minimize the risk for self-
contamination.
b. After removing gloves, hand hygiene should be performed before exiting the patient
room, when feasible.
c. Ensure proper hand hygiene technique when using soap and water.
d. Be aware that hand hygiene adherence may decrease when soap and water is the
preferred method.
