Clostridium difficile infection: How to deal with the problem
Best practice, Surveillance data
Abstract:
This guidance has been produced by a working group established by the HPA’s
Steering Group on Healthcare Associated Infection at the request of the Department
of Health. It outlines newer evidence and approaches to delivering good infection
control and environmental hygiene, highlights the principles set out in various
advisory and guidance documents produced by the Department over recent years,
and updates the 1994 guidance. It takes into account a national framework for
clinical governance which did not previously exist, a framework that gives significant
weight to infection control as a matter of patient safety and highlights that all
clinicians have a personal responsibility for infection prevention and control.
Category:
Control
Epidemiology
Investigation
Management
Prevention
Treatment
Expert Review
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Summary:
In June 2005 the Healthcare Commission received a request from the Secretary of State for Health to undertake an investigation following a problem with Clostridium difficile at Stoke Mandeville Hospital. (Buckinghamshire Hospitals NHS Trust) The interim findings from this investigation by the Healthcare Commission will be published next year. As part of the investigations a national survey was conducted jointly by the Healthcare Commission and the Health Protection Agency to gain an understanding of the issues facing NHS hospitals in relation to the management, prevention and surveillance of infection caused by C difficile. This report consists of the interim results from this survey.It is being published in an interim form to ensure that the important issues being raised can begin to be addressed by NHS Trusts ahead of the winter, the time when prevalence of infection caused by C difficile tends to be at it’s highest.The more detailed findings from the survey will be published by the HPA in the spring of 2006.The interim report consists of information on: -· Clostridium difficile – risks, spread, diagnosis, strain 027 and current guidance· Main reasons for survey and approach taken· Results· Laboratory investigation of and surveillance for Clostridium difficile· Interim findings and observations· Lessons learned and how the HC and HPA will incorporate the findings from the interim and final report into their respective programmes of workThe report outlines three key points that NHS acute trusts should give particular consideration to in relation to the management of C difficile.
Questions Addressed:
The report outlines the results of a survey undertaken jointly by the Healthcare Commission and the Health Protection Agency to gain an understanding of the issues facing NHS hospitals in relation to the management, prevention and surveillance of infection caused by C difficile.
Type of Study:
Surveillance data, best practice
Methods Valid:
Yes
Methods Valid Detail:
Interim report only, more detailed findings from the survey expected spring 2006. A report on the results of the investigation at Stoke Mandeville Hospital will be published later next year.
Results Reliability:
Yes: Questionnaires (see references) sent to Directors of Infection Prevention and Control in 173 trusts (response rate 68%) and results reveal that over a third of trusts surveyed do not routinely follow Government guidelines on the management of C difficile infection in their hospitals
Problems or Biases:
Responses to questionnaire received so far incorporated into interim findings and any further responses received will be incorporated and analysed more fully in final report.
Relevant Studies:
Keywords:
Clostridium difficile surveillance diarrhoea clostridium difficile strain 027 antibiotic prescribing isolation outbreak
Reviewer Name:
Sue Wiseman
Reviewer Post:
Nurse Consultant –Infection Control, DH
Reviewer Affiliations:
Member Advisory Committee on Dangerous Pathogens Health Protection Adviser Royal College of Nursing P/T Member Infection Control Nurses Association