New Study: High-Touch Wipe Downs Dramatically Reduce C. diff Rates Among Cancer Patients

A new study from the University of California, Los Angeles (UCLA) Santa Monica Medical Center found that a “high-touch wipe down” protocol using Clorox Healthcare Bleach Germicidal Wipes to disinfect surfaces in patient rooms in a medical oncology unit reduced C. difficile infections rates per 10,000 patient days from 14.99 the year prior, to zero for a six-month period and helped achieve significant sustained reductions in infection rates. 

The trial was conducted in an inpatient, 26-bed medical oncology unit where despite adherence to UCLA’s policy for early identification of C. difficile, CDI rates had remained above the national median. A nurse-driven “high-touch wipe down” protocol was initiated in February 2015 with the goal of reducing CDI rates by 50% within six months.

Canisters of Clorox Healthcare Bleach Germicidal Wipes were placed in every patient room and at nursing stations and used by nurses and care partners to wipe down high-touch surfaces – including the bed frame, call light, doorknobs, countertops, side table, nightstand, monitor cables, and work stations – once a shift for all patients and twice a shift for neutropenic patients, patients with abnormally low level of neutrophils, a common type of white blood cell important to fighting off infections, particularly those caused by bacteria like C. difficile. The intervention also included employee education. Baseline knowledge of C. difficile prevention was assessed with a pre-survey, followed by a tailored education plan to improve staff understanding of the enhanced disinfecting protocol. Education was provided via informational flyers and trainings during team huddles, staff meetings and annual skills labs and measured with a post-training test.

The results far exceeded expectations. From February to July 2015, the rate of CDIs per 10,000 patient days decreased from 14.99 in 2014, to zero. In 2016, just 6.1 cases per 10,000 patient days were reported, and the most current data from 2017 showed a further decrease to 3.4 cases per 10,000 patient days. 

 Due to its sus­tained success reducing infection rates among vulnerable oncology patients, the simple and inexpen­sive, but highly effective “high-touch wipe down” protocolhas since been implemented hospital wide. According to Maria Quirch, BSN, RN, ONC, Pattie Jakel, MN, RN, AOCN and Laura Alfonso, BSN, RN, ONC, the success of the protocol was recognized by the chief nursing officer and transformational lead­ership shared-governance Magnet council as a nursing best practice and key strategy for fiscal year 2017-2018.