Mercy Medical Center Infection Prevention and Control Policy # 8.00 “Isolation” states nurses may exercise emperic precautions by isolating patients suspicious of an illness requiring transmission-based precautions (isolation). In cases of patients that have a history that places them at risk for Clostridium difficile infection (CDI) and who are exhibiting signs and symptoms, isolation may be initiated, without a doctor’s order until proven otherwise. Nurses are able to order testing on stool to rule out CDI without a doctor’s order under this same policy. However, this suspicion will need confirmation by physician diagnosis.
As a reminder, tests should only be performed on specimens that conform to the container. Formed stool is not acceptable for CDI testing and should be rejected. Testing should be done promptly upon admission for patients under suspicion for CDI to ensure they are properly isolated from other patients and that appropriate precautions are taken to prevent transmission to others. This is also important to ensure the infection is not incorrectly attributed to the hospital.
Per Policy 11.0 “Multidrug-resistant organisms (MDRO’s) and Clostridium difficile,” discontinuation of isolation for patients admitted with or acquiring CDI is based on the completion of antimicrobial therapy and the absence of clinical symptoms. Do not send stool specimen for clearance. At times patients may still have a positive result even though they do not have a current infection as colonization can occur.
Thank you for your assistance to help prevent the spread of Clostridium difficile within the hospital and keep patients safe.