The Cape Breton District Health Authority is focusing on hand washing in its fight against Clostridium difficile infections.

A report released Thursday said its critical that staff and physicians comply with the district's hand hygiene policy if outbreaks of the often fatal infections are to be kept under control.

"Ask your health care professional if they have washed their hands before they treat you simple as that," said John Malcom, CEO of the Cape Breton Regional Regional Health Authority.

Hand washing and the layout of some of the hospital's treatment facilities have been identified as factors in a recent outbreak of C. difficile, Malcom said.

Last spring, half a dozen deaths were linked to the infection.

Following that outbreak, the hospital introduced new cleaning materials and procedures as well as improved equipment.

But another outbreak occurred mid-December and was linked to four deaths.

"The fact that we were able to control this at a very early stage speaks volumes of the measures we have been taking over the last eight or nine months — it never reached the level it was last March, last April," said Dr. Shoaib Ansari, the authority's the infectious disease specialist.

However, Thursday's report into that outbreak outlined concerns about compliance with the facilities hand washing policies.

"We need to reinforce that message we need to make sure everyone understands that message and if someone who doesn't believe that message, we will deal with them in an entirely different way," said Malcom.

Recommendations concerning the disposal of waste and reducing the number of times patients are shuffled around have been followed.

Officials also say additional infection control staff have been hired.