Press Release

Launch of Third National Clinical Guideline on Clostridium difficile (C. diff)

Practical guidance on prevention and control of C. diff will enhance patient safety

The Chief Medical Officer at the Department of Health, Dr Tony Holohan, today (Wednesday 11 June 2014) launched the 3rd National Clinical Guideline – Surveillance, Diagnosis and Management of Clostridium difficile Infection in Ireland.

Along with MRSA, Clostridium difficile which is widely known as C.difficile or C. diff. is the most common healthcare acquired infection in the world. It is a bacteria which, alongside methicillin-resistant staphylococcus aureus bacteremia (MRSA), makes up the most common global healthcare acquired infections (HCAIs).  This National Clinical Guideline provides practical guidance on prevention and control measures for C. diff. to improve patient care, minimise patient morbidity and mortality and to help contain healthcare costs. This includes the importance of organisations having an infection control and prevention programme in place with an emphasis on good hand hygiene, the use of Standard Precautions and antimicrobial stewardship.

“We must systematically build our actions and processes to continue to reduce the prevalence of healthcare associated infections in Ireland. This National Guideline is a significant pro-active step in this direction. I would like to acknowledge the work of the multidisciplinary Clostridium difficile subcommittee of the Scientific Advisory Committee of the Health Protection Surveillance Centre (HPSC) who developed this guideline. I also want to thank the National Clinical Effectiveness Committee (NCEC) for its role in quality assuring and recommending to the Minister endorsement of this important guideline” said Dr Holohan.

Healthcare acquired infections (HCAIs) affect people in hospitals, long-term care and the wider community.  They are one of the leading causes of preventable harm experienced by patients in modern healthcare and cause a significant burden of mortality, morbidity and increased costs.

This guideline has been developed for all healthcare staff involved in the care of patients, residents or clients who may be at risk of or may have C.difficile in hospitals, nursing homes/long stay residential units and the community.

Note to Editors:

The National Clinical Effectiveness Committee
1.        The National Clinical Effectiveness Committee (NCEC) was established as part of the Patient Safety First Initiative in September 2010. The NCECs mission is to provide a framework for national endorsement of clinical guidelines and audit to optimise patient and service user care. The NCEC has a remit to establish and implement processes for the prioritisation and quality assurance of clinical guidelines and clinical audit so as to recommend them to the Minister for Health to become part of a suite of National Clinical Guidelines and National Clinical Audit.
2.        The NCEC, chaired by Professor Hilary Humphreys, is made up of key stakeholders including clinicians, patient representatives, the Department of Health, patient safety experts, health managers, regulatory bodies, training and education bodies, insurance and clinical indemnity agencies and private healthcare.
3.        The NCEC through the processes of prioritisation and quality assurance of a clinical guideline reach consensus as to whether the clinical guideline has been developed using a quality methodology, is based on evidence and is important for the Irish Healthcare system.
4.        Clinical guidelines that meet these criteria are then recommended to the Minister for Health through the CMO for endorsement.
National Clinical Guidelines
5.        National Clinical Guidelines are “systematically developed statements, based on a thorough evaluation of the evidence, to assist practitioner and service users’ decisions about appropriate healthcare for specific clinical circumstances across the entire clinical system”. The implementation of clinical guidelines can improve health outcomes, reduce variation in practice and improve the quality of clinical decisions.
6.        The aim of National Clinical Guidelines is to provide guidance and standards for improving the quality, safety and cost effectiveness of healthcare in Ireland. The implementation of these National Clinical Guidelines will support the provision of evidence based and consistent care across Irish healthcare services so that patients, regardless of where they are in the country or the service they attend, will experience the same high quality, safe, evidence based care.
7.        The implementation of these National Clinical Guidelines also supports services in meeting HIQA’s National Standards for Safer Better Healthcare and anticipated future licensing requirements.

Clostridium difficile

Clostridium difficile is often called ‘C. difficile’ or ‘C. diff’. It is a bacterium that is the leading cause of infectious nosocomial diarrhoea in industrialised countries. Clostridium difficile is usually found in the large intestine (bowel).
The HPSC has been collecting information on Clostridium difficile infection (CDI) in Ireland since 2008.  The HPSC publishes weekly reports of CDI cases and outbreaks and quarterly         reports with more detailed information. www.hpsc.ie  – Go into the Topics A-Z section of the site and then click Clostridium difficile.
The national rate of CDI of new hospital-acquired CDI declined slightly from 2.7 to 2.2 cases per 10,000 BDU from 2009 to 2013. The rate of recurrent CDI has remained at 0.2 cases per 10,000 BDU since 2010. Both new and recurrent rates are less than the European average of 3.7 and 0.3 cases, respectively.

Information on the National Clinical Effectiveness Committee and National Clinical guidelines

Information on Cdiff Guidelines