Failure to Follow Hand Hygiene Protocols for C. diff Precautions
Penalty
Summary
A deficiency occurred when staff failed to follow infection control protocols for proper hand hygiene for a resident on contact enteric precautions due to a Clostridium difficile (C. diff) infection. The resident, who was always incontinent of bowel and had a physician's order for contact enteric isolation precautions, required staff to gown and glove upon room entry and to perform hand hygiene with soap and water upon exiting the room. During observation, a registered nurse (RN) was seen using hand sanitizer instead of washing hands with soap and water after removing personal protective equipment and exiting the resident's room. The RN then proceeded to touch the medication cart without first washing hands as required by the posted precautions and facility policy. Interviews with the RN, the director of nursing (DON), and the infection preventionist (IP) confirmed that the expectation and facility policy were for staff to wash hands with soap and water after caring for residents with C. diff, as hand sanitizer is not effective against the bacteria. The RN acknowledged not following the posted instructions and policy, and both the DON and IP reiterated that soap and water hand hygiene is necessary to prevent the spread of C. diff. Facility policies reviewed also specified the need for hand hygiene with soap and water after glove removal and before touching other surfaces.