Proper disinfection of surfaces is critical because C. diff not only lives on surfaces, but it can spread to and thrive on hands. As soon as clean hands touch contaminated surfaces they are not clean anymore.

With this in mind, Hicks stresses to environmental service providers that they advocate for proper hand washing using soap and water.

Experts emphasize that although soap will not kill the C. diff spore, the physical act of washing and scrubbing hands will remove the bacteria. The same cannot be said for the use of sanitizers.

“Using hand sanitizer does nothing against C. diff,” Tanner says. “We actually sometimes store C. diff spores in ethanol — a common ingredient in sanitizers — and they are happy as a clam in a sea of ethanol.”

Because the compounds of hand sanitizers will not penetrate the C. diff spore, and the act of sanitizing doesn’t wash away the bacteria, experts suggest facilities remove sanitizers from affected areas. St. Luke’s Hospital does just that and covers up hand sanitizer dispensers in C. diff rooms as part of its protocol so affected patients don’t have a false sense of security.

Hospital workers have long known the importance of washing their hands as opposed to just using sanitizers, but they have taken it a step further to educate patients, caregivers and family members.

“I tell patients and their families that you need to advocate for this and insist that before someone administers any care that you see them wash their hands with soap and water,” Hicks says.

Keep Monitoring For C. diff

Departments should revisit cleaning protocols frequently, says Martin, and continually train workers to follow them. She notes that even though the hospital saw a 50 percent decrease in the first six months after the program began, and a further drop the following year, when the hospital’s C. diff infections nudged up slightly in 2012, they reconvened the C. diff task force to figure out why.

“One time we found out the slight uptick was due to environmental services staffing changes, so we had to put our practices back into place immediately,” says Martin. “Another time we found nurses had started bringing their phones into the Intensive Care Unit again and they had to stop that practice. It just goes to show that it doesn’t take much to get you in trouble again. We have this on multiple agendas at all times to keep people on top of what’s going on.”

Cleaning crews can do much to prevent C. diff infections, but only if they keep it on their radar and constantly assess and improve their practices. It’s important — for ill patients, it can be a matter of life and death.   

Ronnie Garrett is a freelance writer based in Fort Atkinson, Wis. She is a frequent contributor to Sanitary Maintenance.

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