An Interprofessional Approach to Reducing Clostridium Difficle Infections

Abstract

Clostridium difficile infections (CDI) are a significant burden for the healthcare system and are associated with increases in morbidity, mortality, and cost. Several factors have been shown to increase patient risk of developing CDI including exposure to the spore and receipt of proton pump inhibitors (PPIs), high-risk antimicrobials, or greater than three different antimicrobials. This project aimed to utilize a multidisciplinary approach to the reduction of CDI through environmental and pharmacological interventions. Environmental interventions included utilization of bleach in high touch areas and increase in frequency of hand hygiene audits. Pharmacological interventions included identification of key provider and pharmacy stakeholders to provide education and increased awareness of CDI risk factors. The interventions were enacted over a two-month period and included staff education, hand hygiene observations, and chart audits. Information from chart audits to determine percentage of patients prescribed PPI, high-risk antibiotic, or greater than three antibiotics was compared to baseline data. Analysis of the data showed there was a reduction in the percentage of patients who were prescribed PPIs and high-risk antibiotics that was not statistically significant. The overall prevalence of CDI decreased significantly during the months the project interventions were in place. Due to several limitations, the exact impact of the project interventions is unclear, but further research is warranted.