Cdiff and med A- would you skill?

** dates are not accurate... Heh.. I'm to tired to be THAT accurate :)

Is the patient actually having multiple loose stools daily? The cdiff spores slough off for months after cdiff infection causing false positive samples. This is why it is not recommended to retest when patient is no longer symptomatic.

According to the cnas and nurses she does...they say it's putty like

I had a patient (pedi) colonized with HAI c. Diff. Now on daily culturelle as published research shows effective for the body to eradicate c diff and reduce loose stools without additional abx wreaking havoc on the gut.

When oh, when is fecal transplant going to become the standard of care for C. Diff?

Resident has had cdiff per MD over 4 months, same back n forth treatment. Resident has not needed IV fluids, has not c/o nausea in over 2 months, actually denies loose stools but she has a bit of STM , with cnas and nursing says she has loose BMs everyday. They state the BMs do not affect daily activities and resident continues to eat/drink the same every day.

Would you continue to skill the resident for the cdiff and vanc observation? Is the Dx of cdiff and contact isolation(res. Leaves room due to loose stools are controlled per Risk manager) orders strong enough to justify skilled daily services? Nursing is always documenting "no s/s n/v,no adverse reactions,adequate po intake, no c/o abd pain, vitals WNL, and etc"

Resident presents with a mild symptom of the disease. The services provided do not meet a skilled level of care.

Exactly what I feel..because we have had cdiff needing way more nursing interventions... Just wish the MD/NP would consider stopping abt and seeing if stool starts to form...kinda like the other person says.. The stools are going to remain positive as long as it's sloughing out/Colonized

We wouldn't skill this resident. PO antibiotics aren't enough to skill someone. We had one resident have CDiff for 6 months. She had the GIFT....first 2 times it didn't work. Finally the 3rd time it worked. She's thrilled...and back home.

May I ask what the GIFT is?

It's a Fecal Transplant. People donate their poop which is then placed inside someone who has CDiff that hasn't responded to medications. The GI docs around here are having good success with the procedure. The newest procedure is easy...the feces are placed in a capsule which doesn't dissolve until it gets into the GI tract.

Also you can't put isolation if they come out of their room at all.

Right.. I never click isolation unles I meet all requirements.. Which I Will never be able to most likely due to our corporate policy states they can cohabitate long as the roommate has no open wounds. ...thought CDC said only if they have the same Dx...but I'm told that if it's in our policy then we do it.