Dynamed references Clinical Practice Guidelines for Clostridium difficile Infection in Adults: 2010 Update by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA).  Infect Control & Hosp Epidemiology. 2010; 31(5): 421-455.
Recommendations for prevention of infection during a hospital outbreak include (definitions of ratings are in Table 1, p. 434):
•    Healthcare workers and visitors must use gloves (A-I) and gowns (B-III) on entry to a room of a patient with CDI.
•    Emphasize compliance with the practice of hand hygiene (A-II).
•    In a setting in which there is an outbreak or an increased CDI rate, instruct visitors and healthcare workers to wash hands with soap (or antimicrobial soap) and water after caring for or contacting patients with CDI (B-III).
•    Accommodate patients with CDI in a private room with contact precautions (B-III).   If single rooms are not available, cohort patients, providing a dedicated commode for each patient (C-III).
•    Maintain contact precautions for the duration of diarrhea (C-III).
•    Routine identification of asymptomatic carriers (patients or healthcare workers) for infection control purposesis not recommended (A-III) and treatment of such identified patients is not effective (B-I).
•    Identification and removal of environmental sources of C. difficile, including replacement of electronic rectal thermometers with disposables, can reduce the incidence of CDI (B-II).
•    Use chlorine-containing cleaning agents or other sporicidal agents to address environmental contamination in areas associated with increased rates of CDI (B-II).
•    Routine environmental screening for C. difficile is not recommended (C-III).

Reviewed JKN 4/14