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Infection Control Policies and Practices for Iowa Long-Term Care Facility Residents With Clostridium difficile Infection

Published online by Cambridge University Press:  02 January 2015

Laura K. Quinn*
Affiliation:
Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa
Yiyi Chen
Affiliation:
Department of Biostatistic, University of Iowa College of Public Health, Iowa City, Iowa
Loreen A. Herwaldt*
Affiliation:
Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa Department of Internal Medicine, the University of Iowa Carver College of Medicine, Iowa City, Iowa University of Iowa Hospitals and Clinics, Iowa City, Iowa
*
Department of Internal Medicine, University of Iowa Carver College of Medicine, 200 Hawkins Drive, Iowa City, Iowa 52242-1081 (loreen-herwaldt@uiowa.edu)
Department of Internal Medicine, University of Iowa Carver College of Medicine, 200 Hawkins Drive, Iowa City, Iowa 52242-1081 (loreen-herwaldt@uiowa.edu)

Abstract

Objective.

To identify infection control policies and practices used by Iowa long-term care facilities (LTCFs) for residents with Clostridium difficile infection or C. difficile-associated diarrhea and to assess use of antimicrobial agents.

Design.

Survey.

Setting.

LTCFs in Iowa that responded between March 25, 2005 (ie, when surveys were mailed), and July 2005.

Results.

Of the 418 LTCFs in Iowa, 263 (62.9%) responded. Most facilities (94.3%) reported that they accept persons known to have C. difficile infection. Few LTCFs reported that clusters of C. difficile infection had been identified. However, only 111 facilities (42.2%) had a protocol to identify residents with C. difficile infection, and most (77.5%) did not test for C. difficile unless a resident had severe diarrhea. Only 58.5% of the facilities placed residents with C. difficile infection in private rooms, and 60.9% cohorted residents infected with C. difficile with other residents with C. difficile colonization or infection. Only 66 facilities (25.1%) have a program to control the use of antimicrobial agents. Staff could use alcohol-based hand gel products after contact with residents known to have C. difficile infection (in 188 facilities [71.5%]) or diarrhea (in 173 [65.8%]). However, the survey did not ask whether the staff used alcohol-based products instead of soap and water.

Conclusions.

C. difficile is present in Iowa LTCFs, but many C. difficile infections probably remain undiagnosed. Staff in LTCFs should be educated about this organism so that they can implement appropriate testing and preventive strategies.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

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