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dc.contributor.authorBruno-Murtha, Lou Annen_US
dc.contributor.authorOsgood, Rebeccaen_US
dc.contributor.authorAlexandre, Caseyen_US
dc.contributor.authorMahmood, Rumelen_US
dc.date.accessioned2017-12-06T16:19:06Z
dc.date.issued2017en_US
dc.identifier.citationBruno-Murtha, Lou Ann, Rebecca Osgood, Casey Alexandre, and Rumel Mahmood. 2017. “A Successful Strategy to Reduce Hospital-Onset Clostridium difficile.” Open Forum Infectious Diseases 4 (Suppl 1): S406. doi:10.1093/ofid/ofx163.1017. http://dx.doi.org/10.1093/ofid/ofx163.1017.en
dc.identifier.issnen
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:34493116
dc.description.abstractAbstract Background: Our goal was to reduce the rate of hospital-onset (HO) C. difficile (CD) by prompt testing in patients with diarrhea on hospital day (HD) 1–3 using a nurse-driven testing protocol (NTP) with PCR and improve identification of disease after HD 3 using a combined toxin/antigen assay (TAA). Methods: An automated best practice advisory/NTP was developed in Epic, triggered by documentation of diarrhea during HD 1–3, to facilitate prompt stool collection, testing and initiation of contact precautions. Education was provided. The NTP was fully implemented at 2 community-teaching hospitals mid-February 2016. The TAA was adopted 7/27/16 for testing after HD 3. Results: In 2016, the standardized infection ratio (SIR) at Cambridge and Everett was 0.43 (P = 0.009) and 0.5 (P = 0.017), respectively, reflecting a 48–61% decrease from 2015. There was a 14–28% improvement in identifying cases as community-onset. The TAA led to a further decline in HO-CD by 10–61%. Refer to the graph for quarterly SIRs before and after implementation. Despite a 26% increase in testing volume, costs are less with the current strategy. Conclusion: Prompt identification of CD improves care and prevents inflation of HO-CD. This strategy has enhanced our efforts to reduce our SIR (observed/expected cases) and resulted in a substantial incentive payment for CHA. Disclosures All authors: No reported disclosures.en
dc.language.isoen_USen
dc.publisherOxford University Pressen
dc.relation.isversionofdoi:10.1093/ofid/ofx163.1017en
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC5630741/pdf/en
dash.licenseLAAen_US
dc.subjectPoster Abstracten
dc.titleA Successful Strategy to Reduce Hospital-Onset Clostridium difficileen
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden
dc.relation.journalOpen Forum Infectious Diseasesen
dc.date.available2017-12-06T16:19:06Z
dc.identifier.doi10.1093/ofid/ofx163.1017*


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