A nurse is caring for a patient with Clostridium difficile infection. Which isolation precaution should the nurse implement?

Core Principle: Implement Contact Precautions immediately upon suspected or confirmed C. difficile infection to interrupt fecal-oral transmission and prevent environmental contamination with resilient spores.

• Personal Protective Equipment (PPE): Don clean, non-sterile gloves and a fluid-resistant gown upon room entry. Perform hand hygiene before donning and after doffing PPE.
• Hand Hygiene: Wash hands with soap and water after glove removal. Alcohol-based hand rubs are not sporicidal and are insufficient against C. difficile spores.
• Patient Placement: Place the patient in a single room with a dedicated toilet or commode. If a private room is unavailable, cohort with another patient with the same active C. difficile infection.
• Dedicated Equipment: Use disposable or dedicated patient-care equipment (e.g., stethoscope, blood pressure cuff, thermometer). Clean and disinfect any shared equipment with a sporicidal agent before use on another patient.
• Environmental Cleaning: Ensure daily and terminal cleaning of high-touch surfaces with an EPA-registered sporicidal disinfectant (e.g., bleach solution). Pay special attention to bed rails, call bells, door handles, and bathroom surfaces.

Maintain Contact Precautions for the duration of the illness, typically until diarrhea has resolved. Some institutions recommend continuing precautions for at least 48 hours after the last episode of diarrhea due to ongoing spore shedding.

• Explain the reason for isolation in simple terms: "We are using special precautions to prevent the spread of a germ that causes diarrhea."
• Instruct visitors to wear gloves and gown when entering the room and to perform hand hygiene with soap and water upon exiting.
• Reinforce the importance of handwashing with soap and water for the patient, especially after using the bathroom and before eating.