Infection control and IV therapy in patients with Clostridium difficile

Clostridium difficile is a spore-forming anaerobe belonging to the family Clostridium, with the bacteria being found in low numbers in approximately 5% of the healthy adult population. Together with meticillin-resistant Staphylococcus aureus, it is a major healthcare-associated infection and is responsible for considerable morbidity and mortality. Antibiotics administered to patients can alter normal gut flora, allowing the proliferation of C. difficile and causing antibiotic-associated diarrhoea and colitis. Such diarrhoea, if severe, can lead to dangerous dehydration and even hypovolaemia, especially in the elderly. To limit the physiological impact of diarrhoea, it is sometimes necessary to administer intravenous therapy. Although good clinical practice demands that infection control should be considered in all clinical situations, specific infection control procedures need to be adhered to when administering intravenous therapy to patients with C. difficile.

Potential pitfalls in adherence to hand washing in the community

Infection control is vitally important in community settings. Community nurses care for people with complex care needs who are extremely vulnerable to infection. The most important thing a nurse can do to prevent the spread of infection is to maintain good hand hygiene. Nurses can face barriers in their efforts to practice good hand hygiene, including lack of education, lack of time, poor facilities and inappropriate clothing and hand adornments. This article outlines evidence-based practice on how to overcome barriers to good hand hygiene and stresses the important role of the community nurse in working with her team to ensure best practice, cut infection rates and save lives.