Multidisciplinary Task Force

1
Cdiff Project
Multidisciplinary Task Force
Infection Preventionist
Administration
Physicians
Environmental Services Personnel
Pharmacy
Registered Nurses
Project Facilitator
2
Selection Purpose

• The Clostridium difficile (Cdiff) project was
  initiated as a hospital-wide priority when
  hospital associated incident rates were high in
  2009.
• Hospital acquired Cdiff was defined in 2009 as a
  new positive toxin test greater than 48 hours
  from admission date.
• The 2009 hospital acquired Cdiff incidence rate
  was 25.27.
• An initial target of a 10 (22.74) reduction was
  set.
• The plan for 2010 was to work in decreasing our
  hospital acquired Cdiff incidence rate using a
  step wise plan.

3
Analysis
Cdiff Project

• Cdiff task force decided on 3 main focuses
• Environmental Cleaning
• Broad Spectrum Antibiotic Use
• Standardization of Clinical Care of Cdiff
  Patients

4
Solutions

• The specific solutions in the 3 main focuses,
  environmental cleaning, broad spectrum antibiotic
  use and standardization of clinical care of Cdiff
  patients, were as follows
• Environmental Cleaning
• Laundry water temperatures adjusted
• Microfiber cloths were added to cleaning
  equipment (more cloths/larger items)
• Dedicated toilet scrubbers stored in bleach
• Twice a day bathroom cleaning of Cdiff isolation
  rooms.
• 2 HAIs too many 3 day course of bleach
  cleaning
• Once per week cleaning with bleach in the ICU
• Decluttering of isolation patient care area
• Proper use of bath basin
• Additional sinks were added in the ICU
• Isolation and hand hygiene fall outs were
  provided immediate feedback
• Pharmacy
• Chart reviews of all HAI cases
• PPI tracking in relation to HAI infections
• Clinical Care of Cdiff patient
• Cdiff order set
• Authority policy for RN to send 1st Cdiff test
  without physician order
• Improvement of specimen collection and transport

5
Hospital Acquired Cdiff

• Housewide Quarterly Incidence Rate per 10,000
  Patient Days