C. difficile and Hand Hygiene for Healthcare Settings

1. C. difficile and Hand Hygiene for Healthcare Settings

2. Clean Hands Save Lives Clean hands are the most important factor in preventing the spread of disease and antibiotic resistance in settings across the continuum of health care. Hand hygiene: • Promotes patient/resident safety and prevents infections • Reduces the incidence of healthcare-associated infections such as C. difficile infection

3. Hand Hygiene for Clostridium difficile • Perform hand hygiene whenever hands are visibly soiled, dirty, or contaminated AND • before putting on gloves • before contact with the patient/resident • after removing gloves • after contact with the environment • before leaving the patient/resident area • after using the restroom

4. Hand Hygiene:Soap vs. Alcohol-based Products • Because alcohol does not kill C. difficile spores, use of soap and water is theoretically more effective than alcohol-based hand rubs. • However, early experimental data suggest that, even using soap and water, the removal of C. difficile spores is more challenging than the removal or inactivation of other common pathogens. • Discouraging the use of alcohol-based hand rubs may undermine overall hand hygiene program with unintended consequences for HAIs in general http://www.cdc.gov/HAI/organisms/cdiff/Cdiff_faqs_HCP.html http://www.shea-online.org/Portals/0/CDI%20hand%20hygiene%20Update.pdf

5. Hand Hygiene for Clostridium difficile(continued) • In outbreaks settings, do not use alcohol-based hand rubs when caring for the C. diff patient/resident – use soap and water • Washing away the spores with soap and water may be the best way to perform hand hygiene when transmission of C. difficile is occurring • Some facilities may choose to use soap and water as the recommended form of hand hygiene all of the time when healthcare workers caring for confirmed or suspected C.diffpatients/residents

6. Monitoring Hand Hygiene Compliance Any possible benefit from instituting a “soap and water only” policy must be balanced against the potential for decreased compliance resulting from a more complex hand hygiene message. Monitoring compliance with appropriate hand hygiene practices is important!

7. Monitoring Hand Hygiene Compliance: Methods The most commonly used method to track rates of hand hygiene compliance is called direct observation, (or the secret shopper), which involves someone watching and recording the hand hygiene behavior of health care workers

8. Hand Hygiene/Isolation Observation Tool

9. In Conclusion • On the surface, hand hygiene may seem like a basic practice, yet it remains an integral important infection prevention strategy in our toolbox and one of the most difficult healthcare worker behaviors to change. • Remember: staff, patient, and resident health is dependent upon hand hygiene compliance.