PPE with C. Diff patient

[Loveyou09]

Hey nurses! I just had a quick question. I'm currently a nursing student and I'm doing clinicals at a LTC/rehabilitation center. So the nurse wanted two of us to give a patient a bath. When we walked into the bathroom in his room there were two red biohazard trash cans inside. We then asked the nurse why they were there. She then says it is because he has c. diff and we will need to wear PPE when giving the shower. But we had previously entered the room multiple times before to give breathing treatments and finger sticks. There were no signs on the door. The nurse herself walked in without PPE.

My question is....Don't you have to wear PPE with a C. Diff patient any time you enter the room? No matter what? When we walked away from the nurse one of the doctors there said you only need to wear PPE when you change/wipe him.

[bgxyrnf, MSN, RN]

Best practice is full contact precautions for every entry, regardless of patient contact.

Perform hand hygiene prior to entering room

Don gown and gloves prior to entering room

Perform care

Just inside the door and away from the patient, doff PPE.

Wash hands for 30 sec prior to exiting room

A sign should be posted outside the door.

[raindrops1234]

What KindaBack said. Contact precaution. I know I don't want to be coming into contact with anything that may have the C-diff spores...gross. Always look out for yourself. And they should definitely have a sign on the door...

[KelRN215, BSN, RN]

Yes, you SHOULD be gowning and gloving with every entry to the room of a patient with C. Diff. Also remember that alcohol based hand sanitizer does not kill C. Diff spores- you need to wash your hands with soap and water before and after entering the room.

[NuGuyNurse2b]

But we had previously entered the room multiple times before to give breathing treatments and finger sticks. There were no signs on the door. The nurse herself walked in without PPE.

My question is....Don't you have to wear PPE with a C. Diff patient any time you enter the room? No matter what? When we walked away from the nurse one of the doctors there said you only need to wear PPE when you change/wipe him.

You will experience that on your own. Pt will be admitted with no reports of diarrhea, then you catch a whiff when they make a bowel movement and your spider senses will tell you uh oh...then the isolation precautions are implemented. It doesn't mean you were careless. You didn't know. But once you do know, or are ruling it out, the proper thing is to maintain the precautions to minimize any further damage.

The reality is, you may be in a situation where donning/doffing every single time is not feasible. If you know you will be doing close contact then yes, it's appropriate for you to be donning PPE. But just standing in the patient's doorway checking if they are still alive, I don't go through the process.

[Fiona59]

New strains of CDiff don't have that wonderful stench.

There are Cdif patients in the community who are discharged home. Their families aren't on isolation. The lucky ones have homes with multiple bathrooms

[FolksBtrippin, BSN, RN]

The MD was wrong. You are supposed to wear the PPE whenever you go in. As a student, make sure you always do this. Nurses and others may choose not to if they aren't touching the patient, and are busy, etc. Don't judge them for that, but still follow best practice yourself as a student.

Ask your clinical instructor these types of questions, not the doc. MDs really don't know about nursing. Ask them patho questions. They are great at that.

If you answered that ppe only needs to be worn when you are changing/wiping a c diff patient on a test you would definitely get it wrong.