Bleach and C diff

[sauconyrunner]

I get a lot of push back (mostly from the environmental Svcs supervisor) at my hospital when I ask for some bleach cleaning of high touch surfaces when we have a high concentration of C diff patients on one unit. I do this of course, pro-actively, so that 6 months down the road we do not have a unit FULL of C. diff, and a bunch of staff who have also had the C. diff experience! (the supervisor always wants to clean with "coverage" which will just move the spores around!) If C diff was visible like Lice, I'd have a much easier time, I am sure.

I was told though recently that one hospital has gone completely bleach free after a bad respiratory experience of the staff. Apparently they are using a different product that kills the C diff spores.

I've been researching it, but can not seem to find such a product. Sooooooooooooo...if any knows of anything can you please share!

[psu_213, BSN, RN]

The other day, one housekeeper in our ER was using something to clean a room that smelled like oven cleaner (and I'm not asthmatic, but I felt like my respiratory passages were closing a bit). Yet at the same time, I like the smell of a room cleaned with bleach--no, I don't want to swim in it, but I like that clean smell. We had a housekeeper who insisted on using some type of orange oil type cleaner. We had an APCT who was allergic to oranges. Point is, 'serious' cleaning supplies are harsh. Some of them really smell bad and can have bad effects on someone (i.e. allergic retains). But, it has to be cleaned. At a certain point EVS just has to use a harsh cleaner for a room. If a problem, they need to wear a mask. When they are done, put a sign up outside the room "This room cleaned with bleach at 1530. If sensitive to bleach, please do not enter this room for 30 minutes after cleaning." But, it has to get done and EVS needs to realize that infection control takes precedence over their wishes.

[trufflelilyRN]

Caviwipes? Do they handle C. diff?

[CrunchRN, ADN, RN]

I would check the CDC website for up to date recommendations. They might take that more seriously than forum advice. You can even call the CDC as I recall if they don't address the issue.

Then come back and educate us.

That C diff scares the _ _ _ _ out of me!

[sauconyrunner]

I would check the CDC website for up to date recommendations. They might take that more seriously than forum advice. You can even call the CDC as I recall if they don't address the issue.

Then come back and educate us.

That C diff scares the _ _ _ _ out of me!

All of these MDRO organisms should scare the bejaseesus out of us all. Cavi wipes do nothing for C diff. Even the CDC recommendations are currently for Bleach...

[CrunchRN, ADN, RN]

All of these MDRO organisms should scare the bejaseesus out of us all. Cavi wipes do nothing for C diff. Even the CDC recommendations are currently for Bleach...

We just had a healthy 60 something adult male out for a month from C diff. And this is a person who works in accounting at a university. Not even close to a hospital!

[RNsRWe, ASN, RN]

Last year I went nuts trying to find something.....I run an endoscopy unit so you BET it's a concern! The CDC was less than helpful.....I actually educated THEM! Ridiculous.

Bleach, yes, but impractical for things such as stretcher mattresses....what am I supposed to do, SUBMERGE them? Of course not...and the multiple times I tried the CDC, the best they could tell me was how to kill c.diff in a water supply (uhh....not the problem) and that I should either BOIL or SUBMERGE my contaminated equipment. Yeah...I'm gonna BOIL my stretchers.

I feel your frustration, Sauconny!

I DID find that glutaraldehyde, the formula we use in our reprocessors to disinfect our scopes *DOES* kill c.diff. (thank heavens for that). But it's not got practical applications for surface disinfection for the rest of the unit.

Finally decided on Discide disinfectant spray (a one-minute kill time for just about everything you can think of EXCEPT c.diff.....and hep A. Yes, THAT's also something no manufacturer seems to want to kill either!). We also use EZ Kill wipes (a 2-minute kill) for the very smooth, non-textured surfaces that are not likely to dry in less than 2 minutes. That's another thing: the kill time is crucial....I DID find something that would kill Hep, but it took FIFTEEN MINUTES of saturation. I tried it out, just for giggles, and found that the surface began drying in mere minutes, which means constant reapplication of spray to KEEP it saturated for a full 15 minutes. Get real. NEVAH gonna happen.

So--Discide for stretchers and most other surfaces. EZ Kill for the things we need to wipe instead of just spray. Rapicide in our reprocessors. Oh, and after much research, Mr. Clean Professional for our floors (DIDECYL DIMETHYL AMMONIUM CHLORIDE) because sodium hypochlorite (comparable) was just way too expensive. And our accreditation agency(s) are fine with all that :)

[Anne36, LPN]

I have noticed that there always seems to be a room that is used for C-Diff patients. Is a 9/1 part bleach solution adequate for cleaning because I think that is what they are using. Ive been noticing more and and more C-Diff cases lately and I have trouble feeling comfortable after these people are removed from contact precaution status. I feel they must still be colonized with spores if not only temporarily negative for C-Diff. Just waiting for them to get rediagnosed after we have all been exposed because 99% of them are incontinent of stool or have peg tubes.

[mariebailey, MSN, RN]

Anne36, that bleach solution is capable of killing C-Diff spores. Some "experts" recommend extending contact precautions 48 hours beyond cessation of diarrhea for C-Diff patients, but the standard is just until the diarrhea ceases. http://www.cdc.gov/hai/pdfs/toolkits/CDItoolkit2-29-12.pdf

[dkstinson]

I have just found that the PDI orange lid, reorder # P25784 is what can be used, per the manufacturer,used for killing the c diff. I found this site while doing my research and some other the other answers were very helpful in me finding this product so I thought I would share what I found. I found that the product is not any higher than any of the others wipes from my vendors. Good luck!

[SummitRN, BSN, RN]

OP, I find that it is really important to understand their objection to the best practice before I search for acceptable alternatives. Sometimes it is an education issue, sometimes it is a solved by different adjuncts whether protective gear or a different product. Why does EVS sup not want to use the bleach?