Jad Antoine Khoury1, William W Sistrunk2, Frances Hixson3, Mary Duncan4, Ann Perry4, Amanda Varble4, Alex M Bryant5. 1. Division of Infectious Diseases, Mercy Hospital, Saint Louis, MO. Electronic address: jad.khoury@mercy.net. 2. Division of Infectious Diseases, Mercy Hospital, Springfield, MO. 3. Mercy Center for Quality and Safety, Mercy Health Systems, Chesterfield, MO. 4. Department of Infection Prevention, Mercy Hospital, Saint Louis, MO. 5. Department of Pharmacy, Mercy Hospital-St. Louis, Saint Louis, MO.
Abstract
BACKGROUND: An automated protocol was designed within our electronic medical record (EMR) to help curb the Clostridium difficile problem at our institution. The protocol will identify patients at high risk for C difficile, improve the timing of testing of patients infected on admission, and enhance the appropriateness of C difficile testing throughout the patient's hospitalization. METHODS: Admitted patients with 2 of the following 3 criteria were labeled as high risk for C difficile: admission to a medical institution in the preceding 90 days, administration of antibiotics in the preceding 90 days, or a history of C difficile. High-risk patients with diarrhea in the first 3 days of admission are identified in the EMR, and prompt testing for C difficile is done. After day 3, if diarrhea develops, a series of questions is presented to help test the appropriate patients for C difficile. RESULTS: A statistically significant reduction in rates of hospital-onset C difficile was achieved after implementation of the protocol. CONCLUSIONS: Implementation of an automated protocol for targeted testing of high-risk patients for C difficile was successful at reducing rates of hospital-onset C difficile by improving timing and appropriateness of testing.
BACKGROUND: An automated protocol was designed within our electronic medical record (EMR) to help curb the Clostridium difficile problem at our institution. The protocol will identify patients at high risk for C difficile, improve the timing of testing of patients infected on admission, and enhance the appropriateness of C difficile testing throughout the patient's hospitalization. METHODS: Admitted patients with 2 of the following 3 criteria were labeled as high risk for C difficile: admission to a medical institution in the preceding 90 days, administration of antibiotics in the preceding 90 days, or a history of C difficile. High-risk patients with diarrhea in the first 3 days of admission are identified in the EMR, and prompt testing for C difficile is done. After day 3, if diarrhea develops, a series of questions is presented to help test the appropriate patients for C difficile. RESULTS: A statistically significant reduction in rates of hospital-onset C difficile was achieved after implementation of the protocol. CONCLUSIONS: Implementation of an automated protocol for targeted testing of high-risk patients for C difficile was successful at reducing rates of hospital-onset C difficile by improving timing and appropriateness of testing.
Authors: Katherine Schultz; Emily Sickbert-Bennett; Ashley Marx; David J Weber; Lauren M DiBiase; Stacy Campbell-Bright; Lauren E Bode; Mike Baker; Tom Belhorn; Mark Buchanan; Sherie Goldbach; Jacci Harden; Emily Hoke; Beth Huenniger; Jonathan J Juliano; Michael Langston; Heather Ritchie; William A Rutala; Jason Smith; Shelley Summerlin-Long; Lisa Teal; Peter Gilligan Journal: J Clin Microbiol Date: 2018-08-27 Impact factor: 5.948
Authors: Catherine Liu; Kristine Lan; Elizabeth M Krantz; H Nina Kim; Jacqlynn Zier; Chloe Bryson-Cahn; Jeannie D Chan; Rupali Jain; John B Lynch; Steven A Pergam; Paul S Pottinger; Ania Sweet; Estella Whimbey; Andrew Bryan Journal: Open Forum Infect Dis Date: 2020-08-21 Impact factor: 3.835