Clostridium Difficile, also known in the medical community as C. diff, is a multi-drug resistant organism that can cause symptoms ranging from mild diarrhea to life threatening kidney failure. Typically known to only affect older adults who are being cared for in a hospital or long-term care facility and who had recently been taking antibiotic mediations, C. diff is shown to be increasing in younger, healthier individuals who have no previous antibiotic use or health care setting exposure. As nurses the idea that we could be exposing patients to C. diff is alarming.
C. diff can be acquired in two ways, by direct contact with the C. diff organism or through anti-biotic therapy that leads to an overgrowth of C. difficile. Recently, a newer,
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more resistant strain of C. diff has been found. This strain of infection exposes patients through direct contact on a surface or through a healthcare worker’s unwashed hands. According to Barbara Sheff in her teaching guide for Nursing Management, “about 20% to 40% of hospitalized patients become colonized with C. difficile shortly after entering the hospital. This may slow your patient’s recovery and lengthen their hospital stay.” C.
Diff presents with many symptoms but the most common is mild to moderate non-bloody diarrhea. Other symptoms may include cramping in the lower abdomen, vomiting, colitis, abdominal distention, and systemic complications including sepsis, electrolyte imbalance and hypotension.
One simple way that nurses can help to stop the spread of C. diff is by ensuring that hand hygiene is taken seriously. It has been shown that alcohol-based hand rubs may be ineffective against the C. difficile spores. This means that a nurse’s routines may not focus as much on “gelling in and gelling out” but on “gelling in, gelling out and washing.” Hands should be washed with an antimicrobial soap for at least 15 seconds, but 30 seconds is preferable. It’s also important that the nurse takes the time to educate the patients and the patients family members about the importance of hand hygiene and proper technique.
Contact isolation techniques are required by the Centers for Disease Control and Prevention for patients that present with C. diff. In her article titled “ Clostridium difficile – Associated Disease : Diagnosis, Prevention, Treatment, and Nursing Care, Maria Pelleschi states, “ All persons entering the patient’s room, including the patient’s family members, must use protective gowns and gloves. Use of dedicated equipment such as thermometers and stethoscopes is also
recommended.” It is also vital that nurses question the use of antibiotics if they seem inconsistent in time or amount with recommended guidelines. Ladenheim et all purposed a specific plan for senior nurses within the health care setting that would help facilitate the monitoring of antibiotic recommended guidelines. “Senior nurses can ensure evidence- based local antimicrobial guidance is in place and reviewed regularly, auditing of antimicrobial guidance occurs, and antibiotic usage data are reported to clinicians and management.” Although C. diff is rising at faster rates and showing an increase in its morality and mortality there are steps that can be put into place by nurses to help cut down on the spread of the organism. Proper hand hygiene, contact isolation precautions, antibiotic monitoring and patient education are just a few of the many ways that nurses can help to step in and reduce C. diff. Having the knowledge on how to reduce instances of C. diff is only enough if healthcare workers are willing to put in the extra work to make sure that precautionary steps are being taken.
Currently, there is no official vaccine that is being used to protect patients against C. diff. Vaccines are currently being developed which targets the specific proteins of the organism that is essential for vaccine development. 5 These proteins produce an immune response when introduced to a host. 5 There are also recent clinical trials that have shown strains of C. diff that only produce toxin B exist and that developing an antitoxin B may be used in defense of an infection. 5 Researchers have also developed vaccine that contains purified versions of toxin A and B. Patients injected with this vaccine had a significant rise of antitoxins during the 30th day of the vaccination regimen. Although this vaccine did not create any adverse reaction and was deemed safe by the researchers it is still under clinical trial. 5
Often patients encompassing with Clostridium difficile have no symptoms or they may express symptoms of mild diarrhea, pseudomembranous colitis, and inflammation of the colon causing pain (Mitchell, 2014). Clostridium difficile is a bacterial infection of the intestine and it may occur in patients who are immunocompromised or taking broad-spectrum antibiotics. Walter (2014) explains that the most important risk factor for CDI continues to be recent administration of antibiotics. The infection occurs from depression of the normal flora of the bowel through the administration of antibiotics. The depression of the normal flora increases the number of C. difficile bacteria within the intestines. The overgrowth of C. difficile causes diarrhea. Abdominal cramps, fever, and leukocytosis are noted in most patients. Symptoms usually begin 4 to 10 days after the initiation of antibiotic therapy (Elsevier,
Metronidazole and vancomycin are indicated for treatment of C.difficile and two studies in animal model suggest that use of culture-specific probiotics, such as S. boulardii can up-regulate anti-toxin a secretary IgA. According to one large study, well-designed study A Randomized Placebo-Controlled Trial of Saccharomyces Boulardii in Combination with Standard Antibiotics f...
A common hospital acquired condition that nurses see now days is clostridium difficile. This bacterium usually invades patients who have been on long-term antibiotics that have killed off bacteria that protect them from infection. C. diff is passed from host to host by both direct and indirect contact making it readily moved from patient to patient in hospital settings (Mayo, 2013, 1). Nurses can use the QSEN competencies and KSAs to help treat and prevent hospital acquired conditions such as C.diff.
CLABSIs are not confined to one unit of nursing care and there are many precipitating factors that may contribute to the development of a CLABSI. Often times these lines are placed in emergent situations in the emergency department (ED) and there may be a break in sterile technique. However a study conducted by Smith, Egger, Franklin, Harbrecht, and Richardson (2011) found a higher incidence of CLABSIs among intensive care unit (ICU) patients compared to those patients whose CLs were placed either in the ED or operating room (OR). This indicates further education for ICU s...
C. difficile infection (CDI) is a dangerous healthcare-associated infection as well as a growing burden, especially with the appearance of more potent strains in the early 2000s. Clostridium difficile was initially identified as possessing the ability to initiate pseudomembranous colitis in the late 1970s. Asymptomatic colonization in healthy adults has been detected in only 3% of individuals, whereas the pervasiveness of such colonization among patients in long-term-care facilities is approximately 50%. People colonized with C. difficile act as a reservoir of contamination by infecting the environment with C. difficile spores, consequently leading to an increase of the pathogen on the hand...
In order to succeed in something, you must know what is expected, have the materials needed and give fourth the effort to do the best of your ability. According to the English 111 syllabus, this course is designed to develop student’s writing ability so that they can portray a clearer message within their writing.
“The CDC is the primary developer of national infection control and prevention guidelines, often in collaboration with its Healthcare Infection Control Practices Advisory Committee, which is responsible for research and dissemination of the latest information for preventing disease transmission” (Griffis, 2013, p. 175). Infection control will continue to be a topic of discussion as long as germ transmission is still happening. Among these studies is the concern the frequent nonadherence to contact precautions is a huge issue that many studies are still very concerned about (Jessee & Mion, 2013, p. 966). The writer is also concerned with the blatant disregard for hand hygiene that appears to be happening in the medical field. What about what is best for the patient. Do the people that do not use proper hand hygiene not understand how important it
To Kill a Mockingbird, the novel by Harper Lee embodies a work of Southern literature, set in the 1930s in a small town in Alabama. The book’s genre exemplifies a coming-of-age historical fiction story. The narrator, a young girl named Scout Finch, describes the lessons she and her brother Jem learn when their father, a lawyer named Atticus, defends an African American man who stands accused of raping a white woman. The novel’s premise revolves around the efforts of a father raising his children and guiding them in their moral development. Along the way, the book deals with the themes of courage, prejudice and maturity. These three concepts are defined differently by Atticus than by most of the other people in the town where he lives. According to Atticus, courage means doing what remains as right and resisting what remains as wrong, even if other people oppose you. In contrast to the prejudice of the townspeople, Atticus believes it important to treat everyone equally. Maturity, in Atticus’ view, refers to having a sense of conscience and seeking to protect those who remain innocent. As these definitions show, Atticus Finch displays a strong sense of ethics. His goal as a parent remains to pass his values on to his children. This paper will argue that Scout and Jem learn the true meanings of courage, prejudice and maturity through the influence of their father and the example he sets for them.
The symbolism and imagery used in the short stories paints a vivid picture into the author’s train of thought. Charlotte Perkins Gilman and Shirley Jackson were not normal writers. The stories are a form of gothic writing. This paper will be analyzing the point of view, symbolism, and setting in the stories The Yellow Wallpaper by Charlotte Perkins Gilman, and The Lottery by Shirley Jackson.
This literature review will analyze and critically explore four studies that have been conducted on hand hygiene compliance rates by Healthcare workers (HCWs). Firstly, it will look at compliance rates for HCWs in the intensive care units (ICU) and then explore the different factors that contribute to low hand hygiene compliance. Hospital Acquired infections (HAI) or Nosocomial Infections appear worldwide, affecting both developed and poor countries. HAIs represent a major source of morbidity and mortality, especially for patients in the ICU (Hugonnet, Perneger, & Pittet, 2002). Hand hygiene can be defined as any method that destroys or removes microorganisms on hands (Centers for Disease Control and Prevention, 2009). According to the World Health Organization (2002), a HAI can be defined as an infection occurring in a patient in a hospital or other health care facility in whom the infection was not present or incubating at the time of admission. The hands of HCWs transmit majority of the endemic infections. As
The systematic review; Interventions to improve hand hygiene compliance in patient care, conducted by the Cochrane Collaboration investigated inventions to improve hand hygiene compliance within patient care. The review included 2 original studies with an additional two new studies (Gould & Moralejo et al., 2010). Throughout the review it was affirmed that among hand hygiene is an indispensable method in the prevention of hospital-acquired infections (HAI), the compliance among nurses’ is inadequate. Nurses are identified within the public as dependable and trustworthy in a time of vulnerability due to their specialised education and skills (Hughes, 2008). Thus, it is imperative that evidence based practice is cond...
(2014) shed light on two key components for infection control, which includes protecting patients from acquiring infections and protecting health care workers from becoming infected (Curchoe et al., 2014). The techniques that are used to protect patients also provide protection for nurses and other health care workers alike. In order to prevent the spread of infections, it is important for health care workers to be meticulous and attentive when providing care to already vulnerable patients (Curchoe et al., 2014). If a health care worker is aware they may contaminate the surroundings of a patient, they must properly clean, disinfect, and sterilize any contaminated objects in order to reduce or eliminate microorganisms (Curchoe et al., 2014). It is also ideal to change gloves after contact with contaminated secretions and before leaving a patient’s room (Curchoe, 2014). Research suggests that due to standard precaution, gloves must be worn as a single-use item for each invasive procedure, contact with sterile sites, and non-intact skin or mucous membranes (Curchoe et al., 2014). Hence, it is critical that health care workers change gloves during any activity that has been assessed as carrying a risk of exposure to body substances, secretions, excretions, and blood (Curchoe et al.,
...s and hoses, control buttons, switches, hand pieces, and X-ray units (Collins). After every patient’s visit, the operatory is to be sterilized and disinfected. All areas that were that were not covered with a barrier, or if the barrier was compromised, must be wiped down with surface disinfectants similarly used in hospitals. OSHA requires disinfectants to be potent enough to fight against HIV and HBV infections (Collins). If there is any blood present on a surface, tuberculocidal type disinfectant should be utilized.
“Researchers in London estimate that if everyone routinely washed their hands, a million deaths a year could be prevented” (“Hygiene Fast Facts”, 2013, p. 1). Hands are the number one mode of transmission of pathogens. Hands are also vital in patient interaction, and therefore should be kept clean to protect the safety of patients and the person caring for the patient. Hand hygiene is imperative to professional nursing practice because it prevents the spread of pathogens, decreases chances of hospital-acquired infections, and promotes patient safety. There is a substantial amount of evidence that shows why hand hygiene is important in healthcare