A comprehensive surveillance, control and management programme for Clostridium difficile infection

The audit showed that simple side-room guidelines such as those developed at St George’s can help to improve the use of limited single rooms and ensure that the highest priority patients are isolated. It is noteworthy that MRSA carriage has a lower priority than many other indications, so that most MRSA carriers remain on the open ward. As was shown by the small number of inappropriate indications, the guidelines need to be combined with active management of single rooms if they are to be effective. The key element of this is daily review of single-room use by senior ward sisters, to ensure that priorities are continually reassessed as clinical conditions change. In the long term, as newer facilities are built, the problem will eventually decrease; but for the foreseeable future, guidance such as this will still be needed in the UK.