Reported to me by a friend, who accompanied her pregnant friend (6th month) to visit a sick patient today at a Boston area rehab hospital. Having visited before, they first went towards the previously assigned room, and a staff person recognized them, and directed them towards a single room instead of the previous double room. While visiting the patient, at least three staff members came in and engaged in conversation, all making notice of the pregnancy of the visitor. In the course of the visit, the visitors held the hands of the patient. A fourth staff member came by and said, "You know you should really be wearing gowns, as the patient has an extremely contagious intestinal infection." It appears that this may have been the reason the patient was moved to a single room. The visitors left the room, put on robes, and returned.
Later the patient informed the visitors that she had C. diff, a very contagious bug. No one on the staff told the guests that C. diff is not killed by the Purell sanitizer, that it takes soap and water cleansing. Fortunately, the guests were aware of that precaution.
I haven't found any literature to suggest that pregnant women are especially susceptible to C. diff infections, or that the fetus will get the disease if the mother gets it. I guess there is something to be said for an enforced weight loss (!) from the diarrhea, but I don't think most pregnant women would choose that path to weight control. Also I have read that, if the infection is persistent and antibiotics must be administered to the mother post-partum, it could be inadvisable to breast feed the baby.
Given the circumstances, this all seemed to me to represent a very casual approach to infection control. Are there any reactions from doctors and nurses out there?
What kind of hospital doesn't post a big red sign from ID and REQUIRE gowns when C. diff is even suspected (until it is ruled out). At least that's what they have done in every hospital I have been in on the West Coast.
ReplyDeleteYes, gowns and maybe also gloves! This was oh so wrong
ReplyDeletePaul, you're quite right. Any health care facility should have signs posted on the room, and nobody should enter without "contact precautions" to use the technical term. Typically, we would recommend gowns and gloves for visitors. And as you say, it's very important to note that waterless alcohol-based hand sanitizers (such as Purell) are much less effective against C. diff than soap and water.
ReplyDeleteInfectious Disease/Infection Control MD
I'm not a medical professional but I do find this terrifying....C. diff is very scary and pregnant women have enough to worry about in terms of infection without such a clear risk...
ReplyDelete