SHM Converge Scientific Abstract ePoster Gallery-Reduction in Hospital-Acquired Clostridiodes Difficile Through Interdisciplinary Team Approach

Pdf Summary

This quality improvement project aimed to reduce hospital-acquired <em>Clostridioides difficile</em> infection (HA-CDI) at Saint Francis–Emory Healthcare, a community hospital. <em>C. difficile</em> is a major cause of healthcare-associated diarrhea and is associated with substantial morbidity, mortality, and cost. The hospital’s standardized infection ratio (SIR) peaked in Q3 2020, prompting a gap analysis and development of targeted interventions.

An interdisciplinary team identified five main prevention strategies: antimicrobial stewardship, a new testing/screening protocol, a diarrhea decision tree, a proton pump inhibitor algorithm, and improved hand hygiene. The antimicrobial stewardship program focused on limiting high-risk antibiotics, especially clindamycin, fluoroquinolones, and third- and fourth-generation cephalosporins. The testing protocol was also revised: instead of using EIA antigen/toxin A/B as a primary screen, the hospital adopted NAAT/PCR for screening, followed by confirmatory EIA testing when PCR was positive. This change reduced false positives and improved diagnostic accuracy.

The project reports that after implementing these interventions beginning in June 2021, the hospital achieved zero HA-CDI cases. The authors conclude that the decline in HA-CDI was largely due to the stewardship program and the improved NAAT/PCR-based testing strategy.

Overall, this project demonstrates that a coordinated, interdisciplinary approach combining antimicrobial restriction, diagnostic stewardship, and infection prevention measures can effectively reduce HA-CDI in a community hospital. Future plans include continued surveillance and ongoing data collection to monitor sustainability of these improvements.

Asset Subtitle

Anand K. Gupta

Meta Tag

Author List Amber Castleberry, Anand K. Gupta, Anupa Rai, Ikshwank Mahajan, Nicholas Kostromin

Category Innovations

Concept Clostridioides difficile Infection

Concept Antimicrobial Stewardship

Concept Hospital-acquired Clostridioides difficile rate

Concept Diagnostic Stewardship

Concept Hospital-Acquired Infection

Distinguished Non-Finalist

Presenter Organization Team Health

Presenting Author Anand K. Gupta

Track Quality Improvement

Keywords

Clostridioides difficile

hospital-acquired infection

quality improvement

antimicrobial stewardship

NAAT/PCR testing

infection prevention

hand hygiene

proton pump inhibitor algorithm

diarrhea decision tree

community hospital

Clostridioides difficile Infection

Antimicrobial Stewardship

Hospital-acquired Clostridioides difficile rate

Diagnostic Stewardship

Hospital-Acquired Infection