Impact of a C. difficile infection (CDI) reduction bundle and its components on CDI diagnosis and prevention.
Am J Infect Control
; 49(3): 319-326, 2021 03.
Article
de En
| MEDLINE
| ID: mdl-33640109
ABSTRACT
BACKGROUND:
Published bundles to reduce Clostridioides difficile Infection (CDI) frequently lack information on compliance with individual elements. We piloted a computerized clinical decision support-based intervention bundle and conducted detailed evaluation of several intervention-related measures.METHODS:
A quasi-experimental study of a bundled intervention was performed at 2 acute care community hospitals in Maryland. The bundle had five components (1) timely placement in enteric precautions, (2) appropriate CDI testing, (3) reducing proton-pump inhibitor (PPI) use, (4) reducing high-CDI risk antibiotic use, and (5) optimizing use of a sporicidal agent for environmental cleaning. Chi-square and Kruskal-Wallis tests were used to compare measure differences. An interrupted time series analysis was used to evaluate impact on hospital-onset (HO)-CDI.RESULTS:
Placement of CDI suspects in enteric precautions before test results did not change. Only hospital B decreased the frequency of CDI testing and reduced inappropriate testing related to laxative use. Both hospitals reduced the use of PPI and high-risk antibiotics. A 75% decrease in HO-CDI immediately postimplementation was observed for hospital B only.CONCLUSION:
A CDI reduction bundle showed variable impact on relevant measures. Hospital-specific differential uptake of bundle elements may explain differences in effectiveness, and emphasizes the importance of measuring processes and intermediate outcomes.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Infection croisée
/
Clostridioides difficile
/
Infections à Clostridium
Type d'étude:
Diagnostic_studies
/
Prognostic_studies
Limites:
Humans
Pays/Région comme sujet:
America do norte
Langue:
En
Journal:
Am J Infect Control
Année:
2021
Type de document:
Article