A roadshow to refresh nursing staff on Clostridium difficile (C.difficile) saw the Infection Control Team speak to over 1,500 front line staff as part of a push to strengthen infection control at Queen Elizabeth Hospital Birmingham (QEHB).

C.difficile is a bacterium (bug) that can be found in the bowel of healthy people and those who are unwell. Around three percent of the population carries C.difficile in their bowel without causing harm. There are millions of normal bacteria that live in the bowel which keep C.difficile under control. When there is an imbalance of the normal bacteria in the bowel, C.difficile may become present in large numbers. When this happens it produces toxins that affect the lining of the bowel and give the symptoms of infection.

The symptoms of a C. difficile infection can range from mild to severe and include diarrhoea and painful abdominal cramps. Early detection of C. difficile is essential to ensure timely treatment and effective precautionary measures to avoid spreading of the disease.

Visiting all wards and departments across a week, infection control specialists spoke to staff about how to prevent the potentially fatal C.difficile infection and the process to follow when a patient is suspected to have or has C.difficile; including the importance of hand washing with soap and water, Bristol stool chart monitoring and effective cleaning.

The team also dispelled myths about the illness. Staff were reminded that alcohol hand rub is ineffective against C. difficile spores and therefore thorough hand washing with soap and water is essential to prevent the spread of  C.difficile and keep both patients and staff safe from harm.

Staff were invited to play ‘Guess poo’, whereby staff had to match some chocolate favourites to the Bristol stool chart, a tool used by staff to classify faeces/stools into types 1-7. Type 5, 6, and 7 are diarrhoea-type stools which could be caused by C.difficile and therefore should be considered for C.difficile testing. Successful staff went away with some goodies and better able to identify type 1-7 stools and the awareness of the need to send stool samples for C.difficile if stool motions are type 5-7 and thought to be due to an infective cause.

The event was also an opportunity to inform staff about the importance of thorough cleaning when caring for patients with C.difficile – to include clinical equipment and the environment, using Chlor clean. This is because C.difficile bacteria can produce spores which can survive for weeks, and sometimes months on objects and surfaces such as bedside cabinets, mattresses, door handles and light switches that haven’t been cleaned correctly, therefore increasing this risk of C.difficile transmission between patients.

As part of the roadshow, the infection control team held a quiz about C. difficile – Sara Bardell from Ward 727 proved to be top of the class on her C. difficile knowledge and walked away with some handy M&S vouchers.

Jane Parkes, IPC Nurse, said: “The roadshow was a hit with staff on the wards – and it was clear that some staff were unaware that we do not need to send a clearance stool sample, and that C. difficile can be cleared with (as well as caused by) antibiotics, it was great to put to bed some of the myths that exist.”

She added: “What is important is for staff to remember that alcohol wipes and gel does not kill C. difficile, you must use soap and water to clean your hands, with a thorough cleaning of all bed spaces with Chlor clean to minimise the risk of passing on this crippling condition that is potentially fatal to our patients.”