Running head: RESEARCH ABOUT C-DIFF 1

Understanding C. difficile (C. diff) disease

Truc La
NorQuest College
NFDN 2003 O02 XL - 2015
Assignment 1: Part A
Jasmine Guanlao Sagun
February 7, 2016

Running head: RESEARCH ABOUT C-DIFF 2

Understanding C. difficile (C. diff) disease
Infection is a one problem that the healthcare facilities or the patients do not want it to
happen during staying in acute or long term care setting; unfortunately, the number of the patient
with super-infection are increasingly in acute care setting. As a result, the tax payer have to pay
more because according to Canada Union Public Employee (2014) reports the direct costs of
hospital acquired infections in Canada are estimated to be $1 billion annually. On top of that are
costs borne by patients and volunteers caregivers as well as program costs for home and
community care. Among with many other super infection such as MRSA, VRE, ESBL, the
number of the patients are infected with C. difficile growing very quickly and Clostridium
difficile infection (CDI) is one of the most common and costly for HAIs (Potter et al., 2014, p.
624). This number is even higher than the patients are having MRSA (Olivo & Ranalli, 2015). In
this research paper, I will discuss some information about C. diff infection such as what is C.
diff, how does it spread, how to treat and prevent this infection from spreading, and the important
of nursing education for family and the patient about this infection.
As we can see that C. diff infection is very prevalent, so what is C. difficile and how does
it spread? Potter et al., (2014) suggest C. difficile is a Gram positive, spore forming, anaerobic
bacillus that produces two toxins, A and B, which cause diarrhea and colitis in patient whose
bacterial flora have been disrupted by prior antibiotic use (p. 624). The nurses, the patients and
the visitors can get C. diff in many ways such as taking antibiotic, poor hand hygiene, touching,
using the same equipment or washroom which was used by the person has infected with C. diff
(Gilreath-Osoff, Heering & Pravikoff, 2014; Public Health Agency of Canada, 2014; Potter et al.,
2014; Olivo & Rannalli, 2015). Treatment for the patient has been infected with C. diff is depend
on the situation. After getting the result from the lab for positive C. diff bacteria, the nurses need

Running head: RESEARCH ABOUT C-DIFF 3

to notify the doctor immediately and place the patient in isolation room for contact precaution
(Gilreath-Osoff et al., 2014). The doctor may prescribe Metronidazole to treat C. diff infection;
however if this antibiotic does not stop the diarrhea, the doctor may order Vancomycin which
may have negative side effect (Gilreath-Osoff et al., 2014). There is the newer treatment called
fecal transplantation which is using stool from a healthy donor the goal is to reconstitute a
normal microbial flora. A systematic review shows a success rate of 92% with very adverse
events (Gilreath-Osoff et al., 2014). On the other hand, preventing the patient from dehydration
is also a priority, therefore, the nurses need to encourage the patient to increase fluid intake
(Potter et al., 2014). Besides that according to Potter et al., (2014) and Gilreath-Osoff et al.,
(2014), the nurses should evaluate the patient skin more often and apply cream to protect the
skin.
The C. diff spores are very difficult to kill which required special solution, and these
spores also can help them to survive for a long time in the environment (Potter et al., 2014,
Gilreath-Osoff et al., 2014). For that reason, the healthcare facility, the patients and the visitors
need to work together. First of all, the nurse should send the stool sample to the lab to check for
C. diff bacteria. The nurses should take extra precaution when providing care for the patients
who show any sign and symptom such as 3-15 watery, unformed, rarely bloody, foul-smelling
stools within a 24 hour period, vomiting, abdominal pain, fever (>38.0 0 C), leukocytosis, edema
and ascites (Gilreath-Osoff et al., 2014). All sharing equipment, the washroom, the furniture in
the room must be clean by special disinfection such as bleach solution of 5000 ppm solution or
10% hypochlorite solution after using for the patient with C. diff (Gilreath-Osoff et al., 2014).
According to Potter et al., (2014) and Public Health Agency of Canada (2014), the best ways to
stop the bacteria spreading is practicing a good hand hygiene, therefore, each healthcare

Running head: RESEARCH ABOUT C-DIFF 4

professional should wash hand with soap and water before entering and after leaving the patient
room. Additionally, patient education is one of the most important roles for nurses in any health
care setting. Patients and family members have the right to health education so that they can
make informed decisions about their health care and lifestyle (Potter et al., 2014, p. 290).
Therefore, the nurses should also educated the patients and visitors the important of hand
washing and follow the contact precaution protocol when entering and leaving the room to avoid
infected or exposure to the bacteria (Gilreath-Osoff et al., 2014).
In all conclusion, whoever has been infected with C. diff infection is not a good
experiences. I believe that everybody needs to have a good knowledge about C. diff infection to
have a better prevent and treatment. Overall, if the professional team, the patient, the family, and
the visitors work together, the health care facility will have a better chance to fight this infection.

Running head: RESEARCH ABOUT C-DIFF 5

References
Canada Union Public Employee. (2014, May 26). Healthcare associated infections:
Backgrounder and fact sheet. Retrieved from http://cupe.ca/health-care-associatedinfections-backgrounder-and-fact-sheet
Gilreath-Osoff, A., Heering, H., & Pravikoff, D. (2014, November 14). Precautions, Contact
Plus: Caring for Patient with Clostridium difficile-Associated Disease (CDAD).
Retrieved from http://ahs.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?
direct=true&db=nrc&AN=T705857&site=nrc-live
Olivo, P. D., Ranalli, T., (2015, July 12). Clostridium difficile infection: the importance of
accurate diagnosis. Retrieved from http://ahs.idm.oclc.org/login?
url=http://search.ebscohost.com/login.aspx?
direct=true&db=rzh&AN=108014122&site=nrc-live
Potter, P. A., Perry, A. G., Stockert, P. A., Hall, A. M., Ross-Kerr, J. C., Wood, M. J. Duggleby,
W. (Eds.). (2014). Canadian fundamentals of nursing (5 th ed.). Toronto, ON:
Mosby/Elsevier Canada
Public Health Agency of Canada. (2014, May 02). Clostridium difficile (C. difficile). Retrieved
from http://www.phac-aspc.gc.ca/id-mi/cdiff-eng.php