C-Diff, and isolation precautions

Vespertinas · Jan 21, 2012

I find it really hard to believe that they stopped isolation precautions on C.diff which can be so problematic. I could maybe even see why someone would be as silly as to not isolate for MRSA in a facility with no open wounds or actually sick people.. but ultimately that's irresponsible to the greater world because you're spreading a resistant bacteria.

I don't know what you're talking about and I hope it's not true.

MomRN0913 · Jan 21, 2012

If anything should have contact isolation precautions it's active C-diff.

katrinabreck · Jan 22, 2012

Some facilities have said that universal precautions should protect us if a patient develops these infections. I was just wanting input because I disagree with not using isolation as well.

horrorxgirl · Jan 22, 2012

The facility I work at does put C-Diff patients on isolation. They don't do it for MRSA though.

tokmom, BSN, RN · Jan 22, 2012

That would be scary to not have C diff precautions! We put even a history of MRSA in isolation. Doesn't matter if it's 20 yrs ago.

craziechiq, BSN, RN · Jan 22, 2012

Anyone with a history gets put on isolation as rule out and they get swabbed. If the swab comes back negative, then the isolation can come down. Also, C-diff is a monster. I would rather keep all my patients safe and isolate.

Vespertinas · Jan 22, 2012

Some facilities have said that universal precautions should protect us if a patient develops these infections. I was just wanting input because I disagree with not using isolation as well.

Universal precautions do not require handwashing which is what is required to minimize transfer of c.diff spores. Again, I do not believe your facility is not isolating for c.diff

MunoRN, RN · Jan 22, 2012

There have changes recently in how many facilities deal with MRSA, but not necessarily C-Diff. At one time, it was assumed that contact isolation for patients with a MRSA history and/or current colonization would reduce the spread of MRSA, although we now know that it doesn't. Universal precautions and standard hygiene (including hand gel/washing) is just as effective. We also assumed that there were no adverse consequences, although we now know that contact isolation significantly worsens patient outcomes and is a safety issue for patients. Now knowing that there is no benefit but there is harm to the patient in using contact isolation for MRSA history/colonization, many facilities no longer use isolation in these instances. The evidence on active infections, particularly those with active drainage, is less clear.

C. Diff on the other hand is a bit different. Unlike MRSA, hand gel is not sufficient. Also, chlorine based cleaners need to be used for the room and equipment. At my facility, we have stopped putting people on C.Diff isolation just because they have diarrhea, but we still do for confirmed C.Diff which I don't see changing anytime soon.

katrinabreck · Jan 22, 2012

I never said it was my facility. I said that I have heard some. I would not put my family at risk.

That Guy, BSN, RN, EMT-B · Jan 22, 2012

There have changes recently in how many facilities deal with MRSA, but not necessarily C-Diff. At one time, it was assumed that contact isolation for patients with a MRSA history and/or current colonization would reduce the spread of MRSA, although we now know that it doesn't. Universal precautions and standard hygiene (including hand gel/washing) is just as effective. We also assumed that there were no adverse consequences, although we now know that contact isolation significantly worsens patient outcomes and is a safety issue for patients. Now knowing that there is no benefit but there is harm to the patient in using contact isolation for MRSA history/colonization, many facilities no longer use isolation in these instances. The evidence on active infections, particularly those with active drainage, is less clear.

I need to find some good research on this because my facility still makes us gown/glove/mask for Hx of MRSA.

MomRN0913 · Jan 22, 2012

That would be scary to not have C diff precautions! We put even a history of MRSA in isolation. Doesn't matter if it's 20 yrs ago.

Really? I was so sure I was getting a private room when I delivered my D because I had a MRSA wound the year prior. Nope:(