Leveraging the Electronic Medical Record to Avoid Hospital-onset Clostridioides Difficile Infections

Document Type

Conference Proceeding

Publication Date

6-1-2025

Publication Title

Am J Infect Control

Abstract

Background: Clostridioides difficile infection (CDI) is a common healthcare-associated infection that can easily spread through or persist in the healthcare environment if not detected early. Early detection of CDI leads to prompt initiation of isolation precautions and treatment. A nurse-driven protocol for CDI testing empowers nursing to initiate testing and isolation at the first clinical indication. The objectives of this project were to improve adherence to the nurse-driven protocol by utilizing a report to identify patients who meet criteria for CDI testing and ultimately reducing the number of hospital-onset C. diff infections (HO-CDI). Methods: The electronic medical record system was utilized to create a report of recent stool documentation for inpatients within the 877-bed facility. A daily report was run by infection preventionists (IPs) to screen for patients with unformed stools documented during the first three days of hospital admission. If patients met criteria, IPs contacted the unit to initiate testing and isolation. The percentage of HO-CDI with unformed stools during the first three hospital days of admission during a 12-month pre-intervention and a 12-month post-intervention period were evaluated. Additionally, the total community-onset C. diff infections (CO-CDI) during the pre-intervention and post-intervention periods were compared. Results: The percentage of HO-CDI with unformed stools during the first three hospital days of admission decreased from 38% (n=25) during the pre-intervention period (n=65) to 24% (n=14) during the post-intervention period (n=58). The number of CO-CDI identified increased by 40%, with 229 during the pre-intervention and 322 in the post-intervention period. Conclusions: Daily utilization of this report has increased awareness of and adherence to the CDI testing protocol. This process has allowed IPs to collaborate closely with nursing and provide real-time education relating to early CDI testing. Through leveraging the technology available, the facility increased early detection of CO-CDI and avoided potential misclassified HO-CDI.

Volume

53

Issue

6

First Page

S37

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