Editing Infection Control and Safety – RN Practice Questions (section)

==Question 2==
The charge nurse on a medical unit is notified of four new cases of ''Clostridioides difficile'' infection in eight days on a unit that averages one case per month. Which action by the charge nurse demonstrates the '''best''' root-cause thinking?
# Instruct all staff to use alcohol-based hand rub more frequently between clients.
# Request an order for oral vancomycin prophylaxis for the remaining clients on the unit.
# Review antibiotic use on the unit and audit hand hygiene and environmental cleaning practices with infection prevention.
# Move all four clients to a single room together and post contact precaution signage.

'''Answer:''' 3. Review antibiotic use on the unit and audit hand hygiene and environmental cleaning practices with infection prevention.

''Rationale:'' A cluster requires identifying the common exposure. Broad-spectrum antibiotic exposure is the dominant risk factor for ''C. difficile'', and inadequate hand hygiene and failure to use a sporicidal disinfectant are the usual transmission drivers. Option 1 is actively wrong because alcohol does not kill spores; soap and water is required. Option 2 is not an accepted practice and worsens antibiotic pressure. Option 4 is partially reasonable, since cohorting confirmed cases with the same organism is acceptable, but signage and cohorting alone do not address why the cluster occurred.