In my previous tip, I laid the groundwork for the problem that C. diff (Clostridium difficile) presents in healthcare settings, be they an acute care hospital, skilled nursing facility, rehab hospital or long-term care facility.

In this and the next Daily Tips, I will give you a total of 13 Strategies for Effective Cleaning and Disinfection of C-diff Patient’s Room. Here are the first 4 strategies (some original with me and others borrowed from “best practices”) that could be adopted by every hospital treating patients with this potentially deadly pathogen:

1. The CDC says, “Because alcohol does not kill Clostridium difficile spores, use of soap and water is more efficacious than alcohol-based hand rubs. However, early experimental data suggest that, even using soap and water, the removal of C. difficile spores is more challenging than the removal or inactivation of other common pathogens.” Consider removing alcohol-based hand sanitizers from the C. diff patient’s room. If the ABHS is not removed, you should use a sign on the container stating, “This product does not inactivate C. diff bacterial spores. Instead, wash hands with soap and water for at least 25 seconds.”

2. Preventing contamination of the hands via glove use remains the cornerstone for preventing Clostridium difficile transmission via the hands of healthcare workers, states the CDC.

3. Ensure adequate cleaning and disinfection of environmental surfaces and reusable devices, especially items likely to be contaminated with feces and surfaces that are touched frequently. Items, such as toilet brushes and  holder, should be dedicated to the isolated patient’s room and discarded at discharge or transfer.

4. Because C. difficile spores resist killing by usual hospital disinfectants, a U.S. Environmental Protection Agency (EPA)-registered disinfectant with a C. diff sporicidal claim should be used to augment physical cleaning. When choosing a disinfectant with a C. diff claim, use the disinfectant that is least corrosive, yet has a C. diff-kill claim (3 minute contact time is optimal). Be sure to observe labeled contact times for a surface to remain wet.


J. Darrel Hicks, REH, CHESP, is the author of "Infection Control For Dummies" and has over 30 years of experience in the jan/san industry. Hicks has served as past president of IEHA and remains an active member of ASHES. He can be reached at through his website at or by email at