Teamwork Tackles C. diff Infections

A team of nurses, infection preventionists and other specialists at Emory Saint Joseph’s Hospital found that multidisciplinary teamwork is key to reducing Clostridioides difficile (C. diff), a common hospital-onset bacterial infection, in health care facilities.

“Our project showed that interprofessional collaboration and continuous improvement can profoundly impact C. diff incidence and sustain reductions over years,” says Cherith Walter, first author on the published study and clinical nurse specialist at Emory Saint Joseph’s. “We hope our findings will help other health care teams to improve patient safety and reduce associated costs.”

Their research, was published in May 2022, in the American Journal of Infection Control.

According to the Centers for Disease Control and Prevention, an estimated 500,000 cases of C. diff occur in the United States annually, making it one of the most prevalent health care associated infections in the country. 

To address the C. diff incidence at ESJH, Walter and colleagues created an interprofessional team consisting of 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 environmental services representative.

The team reviewed C. diff events at ESJH to  determine causative factors, then identified appropriate, evidence-based infection prevention interventions. 

After the first year, the team recorded a 63% decrease in C. diff as compared to the two years prior (4.72 per 10,000 patient days vs. 12 per 10,000 patient days). This number improved further to 2.8 per 10,000 days three years after implementation of the selected interventions (a 77% decrease from baseline). 

Interventions also improved C. diff testing practices, increasing testing for appropriate patients in the first three days of hospital admission from 54% in 2014 to 81.1% in late 2019, to support prompt treatment of infected patients.