A nurse is caring for a client who has a stool culture that is positive for Clostridium difficile.
Which of the following infection control precautions should the nurse take?

The correct answer is Choice D, remove the protective gown while in the client’s room.

Choice A rationale: Wearing a face shield is not specifically required for Clostridium difficile infection (CDI) precautions. CDI is primarily spread through the fecal-oral route, and while a face shield could provide protection against splashes during procedures that might generate them, it is not a standard precaution for entering the room of a patient with CDI.

Choice B rationale: Placing a mask on the client during transport is not a standard precaution for CDI. While it is important to prevent the spread of infection, CDI is not transmitted through the respiratory route, so a mask for the client would not be necessary in this context.

Choice C rationale: Using an alcohol-based hand rub is generally recommended for hand hygiene. However, for CDI, alcohol-based hand rubs are not effective against C. difficile spores. The Centers for Disease Control and Prevention (CDC) recommends washing hands with soap and water after caring for patients with CDI to physically remove the spores from the hands.

Choice D rationale: Removing the protective gown while still in the client’s room is the correct action to prevent the spread of contamination. Gowns should be removed before leaving the patient’s room to avoid dispersing contaminants to other areas of the healthcare facility.

Infection control for CDI involves several specific actions due to the resilience of C. difficile spores. These spores can survive on surfaces for a long time and are resistant to many common disinfectants, which is why environmental cleaning and disinfection with agents effective against C. difficile, such as bleach-based products, are crucial. Additionally, healthcare workers should use gloves and gowns when entering the rooms of patients with CDI and should ensure that these are disposed of correctly after use.