Clostridiodes Difficile (C. diff) In Hospital

Clostridium Difficile (C.diff)

What is Clostridiodes difficile?
Clostridiodes difficile (C. diff) is a type of bacteria that can live naturally in the gut and normally does not cause any harm. However, in some cases it can cause infection and can occasionally lead to serious illness. It frequently follows antibiotic treatment.

These bacteria can survive in the environment for a long time in an inactive form called a spore. You can become infected with C. diff if you ingest the bacterium (through contact with a contaminated environment or person).

People who become infected with C. diff are usually those who have taken antibiotics, particularly the elderly and people whose immune systems are compromised. To protect yourself you need to wash your hands frequently with soap and water as alcohol hand gel is not effective.

Who is at risk?
It can affect anybody, but is more common if you:

• Are over 65
• Are or have been taking antibiotics
• Have inflammatory bowel disease
• Have a weakened immune system
• Have recently had Bowel surgery
• Are taking PPI medications such as Omeprazole

How does the infection occur?
Some antibiotics affect the normal intestinal bacteria, and these changes allow C. diff to become established and multiply.

The bacteria then produce toxins, which damage the lining of the intestine and cause inflammation leading to diarrhoea.

What symptoms does C. diff cause?
Common symptoms of a C. diff infection include:

• Diarrhoea, ranging from mild diarrhoea to frequent watery stools,
• a high temperature,
• loss of appetite,
• feeling sick,
• abdominal pain.
• Occasionally blood may be seen in stools.

Can it be treated?
Yes. Most patients respond very well to stopping antibiotics and ensuring they have adequate fluids.

Some patients may require special antibiotics which are effective on the bacteria in the intestine. Your doctor will decide if you need these and will inform you of any prescribed treatment.

You may be nursed in a single room until your stools return to normal.

For your safety and others, a notice will be placed on your door informing staff of the need to take specific transmission-based precautions.

How have I got C. diff?
You may have already been carrying the bacteria, or you may have acquired it since your admission to hospital.

Can I have visitors?
Yes. Visitors will need to wear an apron and wash/gel their hands before entering your room.

Before leaving your room, your visitors will need to remove their apron, dispose of this in the clinical waste bin (orange) and wash their hands with soap and water.

After leaving your room, your visitors will need to use sanitising hand gel before leaving the ward.

Help us to help you

What you can do to protect yourself

• Hand washing is the single, most important precaution we can all take to remove C. diff and other bacteria, viruses and fungi from our hands.
• Hand hygiene must always be maintained, especially after using the bathroom and before eating. Soap and water are the best way to clean your hands to protect you against C. diff.
• If you are unable to get to the hand wash basins, we will provide you with access to hand wipes and sanitising hand gel for use before your meals.
• Please ensure when using shared bathroom facilities, no personal belongings are left in there after your use.
• All packets of wipes or tissues provided by the hospital are for your use only and are not to be shared with other patients.
• If you have any change in your bowel habits, for example, constipation, loose stools or blood in stools, it’s important you let us know about this.
• Although we understand some patients find it difficult to talk about their bowel habits, it is very important that we keep an accurate record of all our patient’s bowel movements, and we will ask you every day.

This is that chart we use to categorise diarrhoea.

Type 5, 6 and 7 are classed as diarrhoea.

Early detection of C. diff infection is vital to:

• prevent the spread of infection to other patients through isolation
• prevent more severe illness in the affected patient by receiving early treatment.

If you have a type 5, 6 or 7 stool please let us know straight away.

If you would rather complete your own chart, then please let the Nursing staff on your ward know.

Our commitment to you
While you are an inpatient on our wards, we are committed to your safety and doing all we can to prevent hospital acquired infections.

Therefore, we will-

• Monitor your bowel habits to detect changes early
• Send samples to the laboratory at the first opportunity
• Follow the Trust diarrhoea risk assessment to ensure the correct patients are isolated within side rooms as soon as we can.
• If you no longer need a side room, you may be asked to move into a bay to allow us to isolate symptomatic patients.
• We will ensure that the highest standards of cleaning are maintained across our wards.
• We will always adhere to uniform policy and be bare below the elbow to ensure adequate handwashing
• We will adhere to correct hand hygiene.
• We will ensure our staff are all up to date in our infection control training.
• We will only prescribe antibiotics to you in line with hospital guidance and ensure these are reviewed regularly by a consultant on ward round.

If you have any concerns in relation to the cleanliness of your ward then please report to the Nurse in charge, Ward Manager or Matron so this can be addressed immediately.

Thank you to the staff of Aconbury 4 for their contribution to the content of this information leaflet.

Patient Experience
We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you.

Feedback
Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)
If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:
Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:
The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.

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