Clostridium difficile (C. difficile) is the most common cause of acute diarrhea in hospitals and long-term care facilities in North America. More than 60 per cent of C. difficile cases are acquired within health-care facilities. Reducing environmental contamination plays a key role in preventing the spread of infection to immunocompromised patients and health-care workers.
C. difficile is extremely resilient and, depending on conditions, can persist in the open environment for several months. The bacteria’s spores are resistant to common cleaning agents and hand sanitizers making them very difficult to eliminate. Special chemical disinfectants and protocols are required to eradicate C. difficile, but the challenge lies in knowing where the contamination exists in order to take necessary steps to keep our health-care facilities safe.
A multi-disciplinary team at Vancouver General Hospital has developed a program that trains dogs to rapidly and non-invasively detect environmental reservoirs of C. difficile with high accuracy. Since its inception in 2016, our canine detection teams have successfully searched thousands of hospital areas for C. difficile with most hospital units screened in less than 30 minutes. Each contamination alert is acted upon immediately and used as an opportunity for in-the-moment education for health-care workers, cleaning staff and patients. Alert data is also used to design and implement targeted local and system-level quality improvement initiatives.
"[Canine scent detection] is an innovative and exciting way to discover new places where C. difficile might reside. That way we can immediately target problem areas for cleaning and disinfection."
RD, Infection Control Practitioner, VCH
"Having our infection control practitioner attend rounds with Teresa and Angus helps us because we can ask more detailed questions about C. difficile, how it is spread, antibiotic utilization, etc."
JL, Patient Service Manager, VCH
"Having Angus and Teresa as part of our Infection Prevention and Control (IPAC) team has a profound impact on our program and has impacted hospital staff in general in a very positive way. Angus is loved and respected "staff member "of the VGH IPAC team. He captures the attention of the hospital staff, patients, and family, and he is giving Infection Control great PR. Canine scent detection is providing us with a new type of environmental data that has not been readily available before. Nothing can replace the sensitivity of Angus's nose. Quick and swift action following Angus’s alerts is very reassuring to all of us who are striving to provide best patient care."
AIB, Infection Control Practitioner, VCH
"When Teresa & Angus walk through the units, they brighten up everyone's day! The environmental services staff enjoy working closely with them and are always interested to find the results of their searches so they can make sure there are no gaps in cleaning practices."
RR, Operations Manager, Crothall Healthcare, a division of Compass Group Canada
"We have truly enjoyed our yearly visits from K9 Angus. Not only is he well behaved and on point with the job at hand, he is clean and cute; he has a delightful personality that draws in patients and staff alike. His handler was responsive to questions, non-judgemental, knowledgeable, and thorough. They made the ideal pair.
Angus and his handler were part of a quality improvement idea to help eliminate risks of transmission of C. difficile spores by providing a means to educate regarding potential vectors. Both Infection Prevention and Support Services work tirelessly to find new ways to support housekeeping and staff with this important task.
Items identified by Angus as vectors for C. difficile included worn, cracked furniture as well as storage containers which were removed and discarded; it is impossible to clean these items. Additionally, tape and labels often used to help identify clean or dirty items or for signage were identified as sources, unless the proper removal of the adhesive was done.
One of many highlights was the pride two young housekeepers felt after receiving a 100% pass from Angus on an ICU room they had just terminally cleaned.
Currently, regional representatives from NHA are working with Provincial Health Services Authority (PHSA) on a new contract for hospital furniture. We now know the right material, construction and design of furniture makes it much easier to clean, disinfect, and destroy C. difficile spores, thus, diminishing transmission of C. difficile within our hospitals.
Infection Prevention and Support Services are looking forward to Angus visiting four of our acute sites this fall."
Mike Hoefer, Northern Health Regional Director Capital Planning & Support Services
Deanna Hembroff, Northern Health Regional Manager Infection Prevention & Control