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Infection control nurses back ten-point guide highlighting rapid isolation to cut C. diff rates

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Infection control nurses have backed latest Department of Health guidelines on the management of C. diff in hospitals.

The updated guidance, published last week, draws on reports from the Healthcare Commission into outbreaks of C. diff including those at Stoke Mandeville Hospital in Buckinghamshire and Maidstone and Tunbridge Wells NHS Trust.

The report sets out 10 key recommendations that should be followed by all NHS staff to reduce C. diff infection in hospitals, including rapid isolation of patients as soon as C. diff infection is suspected.

If a single room is not available and patients cannot be separated in bays, a designated isolation ward should be set up,
the guidance recommends.

According to Martin Kiernan, president of the Infection Prevention Society, ‘rapid and prompt’ isolation is the most important intervention in preventing the spread of C. diff, and nurses should not wait for diagnosis to be confirmed before acting.

‘The whole purpose of isolation is to try and contain environmental contamination and therefore reduce the risk
to other patients,’ he told delegates last week at an RCN healthcare-associated infections conference in Harrogate, North Yorkshire.

‘Some trusts have been reluctant to go down the route of isolation wards because they see it as an admission
of failure to control the infection,’ he said.

‘But the real failure lies in not considering this to get the situation under control as quickly as possible,’ he added.

As well as providing recommendations on cleaning and hand hygiene, the guidance states that C. diff infection should be treated as a diagnosis in its own right.

It also recommends that all trusts should establish an antimicrobial management team and develop comprehensive restrictive antibiotic guidelines.

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