ASID: Disinfecting for C. diff and How Finishes are Affected
C. diff, or Clostridium difficile, has created a challenge when designing for a hospitality feel in an acute care setting. Typically, carpeting is used to create a softer image, lower general foot traffic noise, and increase the overall level of design. Per the Center for Disease Control (CDC), "Clostridium difficile is a spore-forming, gram-positive anaerobic bacillus that produces two exotoxins: toxin A and toxin B. It is the most common cause of antibiotic-associated diarrhea." C. diff causes diarrhea, which can cause spores to spread through transmission. This typically happens in spots that hands commonly touch: light switches, sinks, door knobs, bed rails, toilet seats, showers, tubs, medicine cabinets, TV remotes, etc. Typically, C. diff is seen in acute care settings and in long-term care nursing when antibiotics are applied. Hand washing is key to discouraging the spread, but the CDC recommends an EPA-registered hypochlorite-based (bleach) disinfectant once C. diff is confirmed. When C. diff is confirmed, the room basically gets cleaned with bleach. While most patient room finishes can handle this as they are predominately hard surface, the corridor flooring may be carpet and may not be a solution-dyed material. The handrails outside of the room will typically be cleaned with a bleach solution, which can drip onto the flooring and wall covering. The mops and mop buckets used from the patient room can also cause an issue.
A strategy of floor protection should be implemented with housekeeping in order to protect the flooring investment and still allow infection control to do their job. The corridor carpeting typically does not have the C. diff spores on it as most of the transmission occurs via hands. But, the possibility exists that the flooring could be contaminated and would need to be able to handle the bleach solution to destroy the spores. It's important that designers know that when moving acute care environments to a hospitality-like area, they need to ensure the fiber type of the carpet is compatible with the possible cleaning methods used when an infection control issue is presented.