An article in the July issue of the Journal on Quality and Patient Safety, published by The Joint Commission, found that "a hospital-wide interdisciplinary approach" can greatly reduce morbidity and mortality associated with C. diff infections.
The article describes efforts to reduce transmission of C. diff at Rhode Island Hospital in Providence, R.I., by 75 percent between 2006 and 2012 through this six step approach:
1. Develop a risk assessment-based plan for controlling C. diff. This plan was the blueprint for the subsequent five steps over six years.
2. Monitor incidence and location of C. diff transmission within the hospital. This information was vital for knowing where to employ preventative methods in combating the spread of the bacteria.
3. Select and implement a sensitive detection test for C. diff in stool samples. A PCR-based approach for identifying C. diff genetic material helped to reduce the rate of false-negative tests, which allowed hospital staff to accurately quarantine infected patients.
4. Improve cleaning methods and procedures for equipment and patient rooms. Rhode Island Hospital brought on additional staff to aid in environmental cleaning. Posted schedules clarifying cleaning timetables and responsibilities also improved environmental cleaning.
5. Create and implement a definitive C. diff treatment plan. An integrated pharmacological and surgical treatment program by infectious disease specialists, surgeons and pharmacists shortened patient recovery times from C. diff-related symptoms so that C. diff exposure was reduced for other patients and hospital staff.
6. Conduct other interventions. Among the other interventions performed were chlorhexidine bed-baths, increased use of antimicrobial agents and increased hospital-wide hand hygiene.
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