Multidisciplinary Task ForceCdiff Project

Infection Preventionist

Administration

Environmental Services Personnel

Registered Nurses

Physicians

Pharmacy

Project Facilitator

•The Clostridium difficile (Cdiff) project was initiated as a hospital-wide priority when hospital associated incident rates were high in 2009. •Hospital acquired Cdiff was defined in 2009 as a new positive toxin test greater than 48 hours from admission date.•The 2009 hospital acquired Cdiff incidence rate was 25.27. •An initial target of a 10% (22.74) reduction was set. •The plan for 2010 was to work in decreasing our hospital acquired Cdiff incidence rate using a step wise plan.

Selection & Purpose

Cdiff ProjectAnalysis

Cdiff task force decided on 3 main focuses:

• Environmental Cleaning

• Broad Spectrum Antibiotic Use

• Standardization of Clinical Care of Cdiff Patients

SolutionsThe specific solutions in the 3 main focuses, environmental cleaning, broad spectrum

antibiotic use and standardization of clinical care of Cdiff patients, were as follows: • Environmental Cleaning

– Laundry water temperatures adjusted– Microfiber cloths were added to cleaning equipment (more cloths/larger items)– Dedicated toilet scrubbers stored in bleach – Twice a day bathroom cleaning of Cdiff isolation rooms.– “ 2 HAIs too many” = 3 day course of bleach cleaning– Once per week cleaning with bleach in the ICU– Decluttering of isolation patient care area– Proper use of bath basin– Additional sinks were added in the ICU– Isolation and hand hygiene fall outs were provided immediate feedback

• Pharmacy– Chart reviews of all HAI cases– PPI tracking in relation to HAI infections

• Clinical Care of Cdiff patient– Cdiff order set– Authority policy for RN to send 1st Cdiff test without physician order– Improvement of specimen collection and transport

Hospital Acquired CdiffHousewide Quarterly Incidence Rate per 10,000 Patient Days

21.1

6.14

3.08

16.2 15.8

33.3

11.7

21.1

11.9

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20

25

30

35

Apr-Jun 09 Jul-Sep 09 Oct-Dec 09 Jan-Mar 10 Apr-Jun 10 Jul-Sep 10 Oct-Dec 10 Jan-Mar 11 Apr-Jun 11

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