Nipigon District Memorial Hospital

 

 

NDMH will post monthly C. difficile data relating to cases and rates on our web site, www.ndmh.ca while the Ministry of Health and Long-Term care posts the numbers and rates for all hospitals on their public web site www.ontario.ca/patientsafety..

Public reporting of C. difficile rates is the first of eight new Patient Safety Indicators that will be publicly reported over the next few months. NDMH strongly supports this public reporting regime as we believe it will inspire improved performance, enhance patient safety and strengthen public confidence in Ontario’s hospitals.

Public reporting of our infection rates is important as it will allow for us to work with a standardized approach across the province. Prior to this, hospitals may have been using different definitions for what constitutes a hospital-acquired infection resulting in a vast difference in reported infection rates.

Gathering of C. difficile rates is not something new to NDMH. We have been conducting surveillance for this organism for a number of years and reflect the Provincial Infectious Diseases Advisory Committee’s (PIDAC) best practice document for the management of C. difficile in our policies and procedures.

 

The C.difficile infection rate is calculated as a rate per 1,000 patient days.

The "total patient days" represents the sum of the number of days during which services were provided to all inpatients and long term care residents during the given time period.

 

 

 

The rate is calculated as follows:

 

 

 

Number of new hospital acquired cases of C.diff in our facility X 1000
Total number of patient days (for one month)

 

 

 

For Smaller Facilities:
C.difficile rates may vary from month to month: the smaller the facility, the greater the rates will vary - this is because a change in even one case in a small facility will cause the rate to go up or down considerably.

Frequently-asked Questions about C. Difficile

 

 

 

1. What is Clostridium difficile (C.difficile)?

 

 

 

C.difficile is a spore-forming bacteria that is widely distributed in the environment and can colonize up to 3-5% of adults in the community (more common in the elderly) without causing symptoms. C.difficile produces spores that are resistant to destruction by many environmental influences. The spread of C.difficile occurs due to inadequate hand hygiene and environmental cleaning. C.difficile as been a known cause of healthcare associated diarrhea for about 30 years.
2. What causes C. difficile?

C. difficile can be picked up on the hands from exposure in the environment and can get into the stomach once the mouth is touched, or if food is handled and then swallowed. Once in the stomach, the bacteria usually will not cause any problems unless the other bowel bacteria are disturbed, which can happen when antibiotics are taken. The use of antibiotics increases the chances of developing C. difficile diarrhea as it alters the normal level of good bacteria found in the intestines and colon. Without the presence of the normal bowel bacteria, the C. difficile bacteria may start to grow and produce a toxin that can damage the bowel and lead to watery diarrhea, fever and abdominal pain or tenderness.
3. What are the risk factors for CDAD?

Certain people are at increased risk for acquiring CDAD. These risk factors include:
• History of antibiotic usage
• Bowel surgery
• Chemotherapy
• Prolonged hospitalization
• Being elderly
• Serious underlying illness or debilitation
4. How does C. difficile spread?

When a person has C. difficile, the bacteria in their feces can contaminate surfaces such as toilets, bedpans, commode chairs, and door handles (if feces is on hands). Other healthy individuals can contaminate their hands if they touch these items. If these individuals then touch their mouths without washing their hands, they can become infected. C. difficile produces spores that survive for long periods and are resistant to destruction by many environmental factors (e.g. temperature, humidity).

 

 

 

5. Does public reporting of CDAD apply to all hospitals or just all acute hospitals?

 

 

 

The requirement to report to the public on CDAD applies to all Ontariopublic hospitals.

 

 

 

6. How important is hand hygiene?

 

 

 

It is everyone’s responsibility. Good hand washing by everyone, healthcare staff, physicians, volunteers, patients and visitors, is the single-most effective way to prevent the spread of infectious diseases like C. difficile.

 

 

 

 

Our Strategies:
NDMH has many strategies in place to reduce the spread of healthcare-acquired C. difficile. We have staff trained in Infection Prevention and Control. Within our facility, we are fortunate to have hand-washing sinks in every patient room. Continuous promotion of hand hygiene for visitors, patients and staff is ongoing with alcohol-based hand sanitizers prominent throughout the facility. Environmental cleaning is ongoing with well-trained and dedicated housekeeping staff. We want to stress that good hand-washing by everyone is the single-most effective way to prevent the spread of any infectious disease such as C. difficile.

 

 

 

If you have further questions about C-Difficile, please contact Sean Normore, Infection Control lead at

 

 

 

887-3026 ext 246

 

 

 

 

 

 

 

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