Safety and Infection Prevention and Control

C. diff room entry: what matters most?

Question

A nurse is about to enter the room of a client with confirmed Clostridioides difficile (C. diff) diarrhea. Which statement matches CDC's hand hygiene guidance for this situation?

  1. APut on a gown and gloves before entering, and take the gloves off carefully to avoid contaminating the hands.
  2. BNever use alcohol-based hand sanitizer, because it is not acceptable for C. diff.
  3. CWear an N95 respirator, because the spores spread through the air.
  4. DClean the hands with a bleach disinfectant wipe after leaving the room, because bleach kills the spores on surfaces.
Show the answer and rationale

Correct answer: A

  1. A. Correct. CDC says the priority on entering a C. diff room is glove use, in addition to a gown, with careful glove removal to avoid self-contamination. It notes that spores may not be fully removed from hands by any cleaning method, so gloves are the main barrier.

  2. B. Incorrect. CDC still prefers alcohol-based hand sanitizer in most clinical situations, C. diff care included, unless hands are visibly soiled. It lists soap and water for the care of C. diff patients during outbreaks, and facility policy may ask for soap and water too, but "never" goes further than CDC does.

  3. C. Incorrect. C. diff passes from contaminated surfaces and items to patients on the hands of staff, CDC says. It is not an airborne infection.

  4. D. Incorrect. Disinfectant wipes are for surfaces and equipment, not skin. Hand hygiene uses hand sanitizer or soap and water.

Source: CDC: Clinical Safety: Hand Hygiene for Healthcare Workers

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