ÎEnsure cleaning and disinfection of equipment and the environment (B-III for equipment and B-II for the environment).
ÎImplement a laboratory-based alert system to provide immediate notification to infection prevention and control and clinical personnel about patients with newly diagnosed CDI (B-III).
ÎConduct CDI surveillance; analyze and report CDI data (B-III).
ÎEducate healthcare personnel, housekeeping personnel, and hospital administration about CDI (B-III).
ÎEducate patients and their families about CDI as appropriate (B-III).
ÎMeasure compliance with Centers for Disease Control and Prevention or World Health Organization hand-hygiene and contact precaution recommendations (B-III).
Special approaches for the prevention of CDI**
ÎPerform a CDI risk assessment. ÎApproaches to minimize
transmission by healthcare personnel
> Intensify the assessment of compliance with process measures (B-III). > Perform hand hygiene with soap and water as the preferred method before exiting the room of a patient with CDI (B-III).
> Place patients with diarrhea under contact precautions while C. difficile test results are pending (B-III).
> Prolong the duration of contact precautions after the patient becomes asymptomatic until hospital discharge (B-III).
ÎApproaches to minimize CDI transmission from the environment
> Assess the adequacy of room cleaning (B-III). > Use sodium hypochlorite (bleach)-containing cleaning agents for environmental cleaning. Implement a system to coordinate with the housekeeping department if it is determined that sodium hypochlorite is needed for environmental disinfection (B-II).
ÎApproaches to reduce the risk of CDI acquisition > Initiate an antimicrobial stewardship program (AII).
Approaches that should CDI prevention
be considered a routine part of
> Patients without signs or symptoms of CDI should NOT be tested for C. difficile (B-II). > C. difficile testing should NOT be repeated at the end of successful therapy for a patient recently treated for CDI (B-III).
* Recommended for all acute care hospitals. ** These special approaches are recommended for use in locations and/or populations within the hospital for which outcome data and/or risk assessment suggest lack of effective control despite implementation of basic practices.
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