We often see those tasked with finding suitable isolation facilities counting down to when precaustions can be discontinued and the ’48 hours clear’ of symptoms of loose stools or vomiting has almost become one of the most welcome statements heard in healthcare settings. No more contact precautions, no more disinfectants sloshing around, normality beckons.. Or should it?
A new paper from Curtis Donskey’s group in the US studied the level of hand contamination with C. difficile after the magic 48 hour period was up and hand contamination occurred as frequently during the care of patients with recently resolved CDI (12%) as during the care of CDI patients (21%, despite the 100% use of gloves) P= 0.20. Interstingly the frequency of acquisition of spores on hands was similar for nurses, doctors and allied health porfessionals with a moderate positive correlation between time spent with a patient and acquisition. The 21% acquisition from contact with cases within the active period despite the use of gloves is interesting and reinforces my view that we are not there with the safe use of PPE just yet, despite the boost that Ebola training may have provided.
In the words of the song on Contact Precautions from David Soul ‘Don’t give up on us baby”