Reducing Clostridium Difficile Infections
One major component of preventable harm is hospital-acquired C. difficile infections. Due to the ongoing work of Deb Gregson and the QI team, we have made considerable progress. BMC is above goal with FY18 Standardized Infection Ratio (SIR) of 0.97 (goal ≤0.7).
Key drivers for reducing C diff. are decreasing unnecessary testing, ensuring timely isolation/contact precaution adherence, antibiotic stewardship, and washing hands with soap and water. Ways to help:
- Do not send C diff. test unless > 3 loose or watery stools in a 24 hour period.
- Do not retest within 7 days of a previous negative, within 30 days of a previous positive C diff. test result, or if the patient has had a positive result within the current admission (prior results will be made available when order placed).
- No need to test for cure
- BPA will alert you if the patient has received laxatives in past 48 hours.
- If you have a suspicion for C diff., place Contact PLUS Isolation Precautions which is part of the C diff. test order.
- Whenever you enter a patient’s room on Contact PLUS, Wash in, Gown up, Glove up. Dispose of dress in room and SOAP OUT.
- Discontinue precautions if test is negative.
- Use oral vancomycin as first line treatment for C diff. (thought to have more rapid response than metronidazole and reduce contagion more quickly.)