Improving C. diff Infection Control in Long-term Care Facilities

Robin Jump, MD, PhD, assistant professor in the Department of Medicine at the Case Western Reserve University discusses ways to improve infection control for C. difficile in healthcare facilities.

Interview Transcript (slightly modified for readability)

“Some other ways that we can improve infection control of [Clostridium difficile] C. diff in long-term care facilities [is] to consider extending the isolation time. Some places have policies where once someone is continent of stool after 48 hours, they come out of contact precautions or isolation precautions. That may not be long enough. Sometimes the C. diff will recur; that happens often among older adults, up to 30% of the time. By the time [this has] recurred they’ve become an infectious risk again and that poses a problem for everyone else in the facility.

What one facility in my area has done, with great success, is they keep a stool chart. They monitor for up to two weeks after someone has been off of therapy for C. difficile how often [patients] are going to the bathroom, and if they see early signs of diarrhea, they [are put] right back on the contact precautions and they start thinking about [if] they need to reinitiate therapy for C. difficile. They’ve had great success; I think it’s a fantastic and practical approach.

Another innovation from this particular facility is that they put all of their C. diff patients or residents that are going to participate in rehab [and] they schedule those folks at the end of the day so that all [of] the equipment can be wiped down thoroughly with bleach and they don’t have to worry about getting the next person in. [Therefore], they can do a really thorough job and all [of] the equipment is clean and ready to go the next morning.”