Interprofessional Collaboration Leads to Reduction in Hospital C. Diff Infections

Health care facilities can significantly reduce the rate of hospital-onset C. difficile (C. diff) by establishing teams that contain members across all professions—from physicians to environmental services (EVS) staff—for implementation of evidence-based infection-prevention protocols, according to a study published this week in the American Journal of Infection Control.

C. diff is one of the most common health care-associated infections (HAIs), with an estimated 500,000 cases occurring in the U.S. annually, according to the U.S. Centers for Disease Control and Prevention (CDC). Emory St. Joseph’s Hospital, a 410-bed community hospital in Atlanta that was above C. diff infection (CDI) benchmarks set by the U.S. Centers for Medicare and Medicaid Services (CMS) created an interprofessional team to lower its CDI rate. The team included a clinical nurse specialist, a physician champion, a hospital epidemiologist, an infection preventionist, a clinical microbiologist, unit nurse champions, an antimicrobial stewardship pharmacist, and an EVS representative.

 The team reviewed CDI events at their facility between 2014 and 2016 to determine the causes, then identified appropriate, evidence-based infection prevention interventions that included enhanced environmental cleaning. After the first year with the team and interventions in place, project leads recorded a 63% decrease in CDIs compared to the two years prior (4.72 CDIs per 10,000 patient days versus 12 CDIs per 10,000 patient days). Three years later, the CDI rate dropped to 2.8 per 10,000 patient days, a 77% decrease from the baseline.

“Our project showed that interprofessional collaboration and continuous improvement can profoundly impact CDI incidence, and sustain reductions over years,” said Cherith Walter, a nurse at Emory St. Joseph’s Hospital and a study author. “We hope our findings will help other health care teams struggling with this incredibly challenging health care-associated infection to improve patient safety and reduce associated costs.”