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Registration Number: {{org_field_registration_no}}

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Clostridium Difficile (C. diff) Infection Prevention and Control Policy

1. Purpose

The purpose of this policy is to ensure that {{org_field_name}} has a comprehensive and effective approach to preventing, managing, and controlling Clostridium difficile (C. diff) infections within the care home. This policy aligns with Care Inspectorate Wales (CIW) regulations, Public Health Wales (PHW) guidance, and the Health and Social Care Act 2008. By implementing robust infection control measures, we aim to protect service users, staff, and visitors from C. diff infections and maintain high standards of hygiene and safety.

2. Scope

This policy applies to all employees, agency staff, volunteers, and healthcare professionals within {{org_field_name}}. It covers:

• Prevention strategies to minimise the risk of C. diff transmission.
• Early identification and reporting of suspected cases.
• Effective infection control measures for managing confirmed cases.
• Staff training and competency requirements.
• Compliance with legal and regulatory infection control standards.

3. Understanding Clostridium Difficile

C. diff is a bacterium that can cause severe diarrhoea and life-threatening complications such as colitis. It is transmitted through contact with contaminated surfaces, healthcare equipment, and person-to-person spread via hands. Those at higher risk include:

• Older adults (especially those aged 65 and over).
• Individuals on long-term antibiotic therapy.
• Service users with weakened immune systems.
• Those with prolonged hospital stays or prior exposure to healthcare settings.

4. Prevention Strategies

To minimise the risk of C. diff transmission, {{org_field_name}} implements the following preventive measures:

• Strict hand hygiene: Staff must wash hands thoroughly with soap and water before and after providing care. Alcohol-based hand sanitisers are not effective against C. diff spores.
• Antibiotic stewardship: Close monitoring and controlled prescribing of antibiotics to reduce the risk of C. diff overgrowth.
• Environmental cleaning: Daily cleaning and disinfection of high-touch areas, toilets, and shared equipment using chlorine-based disinfectants.
• Safe food handling: Ensuring proper food hygiene practices to prevent contamination.
• Use of Personal Protective Equipment (PPE): Staff must wear gloves and aprons when caring for infected individuals and dispose of them safely.

5. Early Identification and Reporting

Prompt identification of suspected C. diff cases is essential to prevent outbreaks. Staff must be vigilant for the following symptoms:

• Frequent watery diarrhoea (at least three episodes in 24 hours).
• Abdominal pain or cramping.
• Fever and nausea.
• Dehydration and weakness.

If C. diff is suspected:

1. Isolate the service user immediately in a single occupancy room with dedicated toilet facilities.
2. Inform the Infection Control Lead and escalate to the GP and local health protection team.
3. Obtain stool samples for laboratory confirmation.
4. Record the case in the service user’s care plan and infection control log.

6. Managing Confirmed Cases

If a service user tests positive for C. diff:

• Isolation Precautions: The individual must remain in isolation until they are symptom-free for at least 48 hours.
• Enhanced Cleaning Protocols:
  • Use chlorine-releasing disinfectants to clean the affected areas.
  • Increase cleaning frequency, especially in shared areas.
  • Dedicated care equipment (e.g., commodes, thermometers) must be used and thoroughly disinfected after each use.
• Appropriate Use of Antibiotics:
  • Review and adjust antibiotic therapy as directed by the GP.
  • Monitor for signs of dehydration and electrolyte imbalances.
• Safe Waste Disposal:
  • Contaminated waste, including PPE and incontinence pads, must be disposed of in designated hazardous waste bins.
  • Linens and clothing from infected individuals should be laundered separately at high temperatures.

7. Staff Training and Competency

All staff must undergo mandatory infection prevention and control training, covering:

• Modes of C. diff transmission and risk factors.
• Proper hand hygiene and PPE usage.
• Environmental decontamination and safe handling of waste.
• Recognising early symptoms and reporting procedures.
• Emergency response protocols for outbreaks.

Training must be refreshed annually, with additional competency checks for staff directly involved in care provision.

8. Outbreak Management and Reporting

If multiple cases of C. diff occur, {{org_field_name}} will:

1. Declare an outbreak and notify the Local Health Protection Team and CIW.
2. Implement cohort nursing, assigning dedicated staff to infected individuals to prevent cross-contamination.
3. Suspend communal activities and visits where necessary to reduce transmission risks.
4. Monitor all service users for symptoms, conducting regular health assessments.
5. Conduct a full infection control audit to identify any lapses in hygiene protocols.

9. Compliance and Monitoring

The Registered Manager and Infection Control Lead are responsible for:

• Ensuring adherence to infection prevention protocols.
• Conducting regular infection control audits.
• Reviewing staff training records and providing refresher courses.
• Investigating any infection control breaches and implementing corrective actions.
• Maintaining accurate records of all confirmed and suspected C. diff cases.

10. Related Policies

This policy should be read alongside:

• CHW11 – Safe Care and Treatment Policy
• CHW16 – Health and Safety at Work Policy
• CHW17 – Infection Prevention and Control Policy
• CHW22 – Handling and Disposal of Hazardous Substances Policy
• CHW36 – Initial Assessment and Care Planning Policy

11. Policy Review

This policy will be reviewed annually or sooner if required due to changes in CIW regulations, Public Health Wales guidelines, or infection control best practices.

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Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
Copyright © {{current_year}} – {{org_field_name}}. All rights reserved.