Title : A multidisciplinary approach in reducing C. difficile incidence rates in a rural hospital utilizing Innovative strategies
Abstract:
Background: Health-care-associated infections have become one of the most prevalent complications of hospitalized patients in the United States. In 2020 the crude overall incidence rate of C. difficile infection (CDI) was 101.3 cases per 100,000 (CDC, 2023). The aim of this study was to identify the factors contributing to the significant increase in the incidence of C. difficile cases from CY 2021 to CY 2022 (SIR 0.701 to 1.239) and the multimodal approach embraced to achieve a reduction rate of 55.55% in CY 2023 successfully.
Methods: Assessment of staff knowledge?, implementation of best safety practices?, monitoring outcomes and providing feedback to stakeholders, reviewing charts of all the CDI cases from CY 2022 to identify and compare all the factors commonly known to contribute to the transmission of C. difficile in the hospital setting? including patient demographics?, presenting signs and symptoms of the patients?, culture techniques, processing, screening, and surveillance of the patients admitted?, environmental service policies and practice were some of the methods that were monitored closely. Purposeful rounds by all the stakeholders-infection prevention, nursing leaders, medical directors, hospital leadership, quality manager, etc., to enforce proper signage, effective transitions and sign out communication between various departments, focus on hand washing and infection prevention and educating all the auxiliary staff including EVS, Nutrition, Lab and visitors and reporting days since last incidence in weekly safety huddles were some of the interventions put in place.
Results: Incidence of new C difficile cases reduced by 55.5% in CY 2023 from CY 2022 and low rate continues till date.
Conclusion: There were significant reductions in CDI upon implementation of enhanced and innovative interventions: daily and terminal cleaning, staff and patient hand hygiene, screening at admission, purposeful rounding and effective education.
