CDiff Handwashing Protocol

[JoeShoes]

Hi allnurses,

I'm a new student nurse and had my first experience caring for a patient with Cdiff today. I understand that Cdiff requires hand washing after the removal of PPE; however, I'm a bit confused as to where I should be hand washing after providing care. Is it common to use a patient's bathroom sink after removing PPE (which has the potential to be contaminated and leaves me unprotected while in the patient's room), or is it acceptable to go to the nearest staff bathroom located directly across the hall at the nurse's station? If you find the latter option to be more appropriate, would you use hand sanitizer when leaving the patient's room as you walk to the staff bathroom to wash your hands?

Thanks for the feedback!

[smf0903]

We doff in patient's room and dispose of PPE in there then wash hands in room. Hand sanitizer is not indicated for CDiff because it doesn't kill spores (although I understand what you're saying about sanitizer and then washing hands).

[Here.I.Stand, BSN, RN]

That's why you use a paper towel to turn the water off -- so you don't re-contaminate your washed hands. If you leave the pt's room to wash elsewhere, you take the C. diff with you.

[tsm007]

Definitely wash your hands IN THE ROOM. There are a couple pt rooms where I work that the sink is not near the exit to the room and that's very frustrating to me. We actually had this discussion recently and our safety/infection nurse who is very knowledgeable and good at her job says wash in the room even if you have to pass back by the pt's bed before getting to the door. I don't like this so I usually doff and wash hands then hit hand sanitizer again at the door (WHICH I KNOW DOES NOT KILL C DIFF), but any other germs that I might have hit before the door it's not going to hurt right. Then I immediately wash again at the closest sink outside of the room. In the perfect world the sink would be at the door where you doff, but keep in mind many facilities are older so they just weren't designed that way.

[JoeShoes]

Thank you for your comments and explanations, I really appreciate them!

[imhorsemackerel, LPN]

I just wanted to add... when I went to clinicals, my instructor mentioned that as soon as we left a room, we had to use hand sanitizer. Even if we just washed our hands, we had to use hand sanitizer because when we come out of the room, a staff member may assume you didn't wash your hands. However, one could also assume you didn't wash your hands and just used hand sanitizer after coming out of the room where a patient has c diff.

As others mentioned, definitely wash your hands in the room and use a paper towel to turn off the sink. And if your instructor was as paranoid as mine, then use hand sanitizer as well after leaving the room.