Stubborn, Persistent, Dangerous C.difficile Infections. Is Improvement Possible?

Authors

Sara Townsend, Jefferson School of Population Health, Thomas Jefferson UniversityFollow

Document Type

Presentation

Publication Date

8-30-2012

Comments

Committee: J Pelegano, MD, MS, Jefferson School of Population Health

Abstract

C.difficile also known as C.diff or CDI has developed into a dangerous infection for the United States’ health care system. While much work has been done to improve C.diff rates, health care teams have not been successful in reducing C.difficile infections. Many studies have focused on the mode of transmission of C.difficle, yet there still is not consensus on understanding how this infection is spread. Bryn Mawr Hospital, a community hospital in the suburbs of Philadelphia, Pa, has struggled to improve their C.diff rates like their peers throughout the country. While their infection rates for C.diff are lower than the national average, their C.diff rates vary depending on the month, with no standout reason to explain why. The infection prevention team at Bryn Mawr Hospital wondered why they could not maintain their low C.diff rate or reduce that rate to nearly zero, as had been accomplished with other types of infections in their hospital. With this question in mind, the infection prevention project team developed an improvement project to decrease the rate of C.difficle by interfering directly with the transmission of C.difficle spores. The team’s strategy was to first educate healthcare workers who most came in contact with C.diff spores and then to provide multiple opportunities to end the careless spread of these spores. Departments that participated in the intervention included nursing, patient care techs (PCTs), environmental services group (EVS), nutrition and the patients themselves. While the education and plan to improve the cross transmission of C.difficile was well received at Bryn Mawr Hospital in all groups that were educated, there were many barriers to realizing actual improvement in reduced rates of C.difficle in the timeframe of this study. Time, a change in testing strategies for C.difficile and other hospital initiatives stood in the way of a quick understanding if improvement has in fact occurred. However, in time, if the methods are continued, and the different departments work together, improvement may be seen.

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