In the past decade, the incidence and severity of hospital acquired Clostridium difficile (CDI) infections has increased dramatically in the United States. Research reported in the Journal for Healthcare Quality (JHQ), however, demonstrates that a collaborative multi-hospital model using standardized clinical infection and environmental cleaning programs can be effective in controlling the spread of this pathogen.
JHQ is the peer-reviewed publication of the National Association for Health Care Quality (NAHQ, www.nahq.org).
Treating CDI and its complications costs the U.S. healthcare system more than $3.2 billion annually, and mortality is now estimated at 23.7 deaths per million. Therefore, interventions that interrupt CDI transmission are a critical component of CDI prevention programs.
The study reported the outcome of a collaborative program in which 35 acute care hospitals in the New York metropolitan area participated in a comprehensive CDI reduction intervention and formed multidisciplinary teams to implement the program. New York has the highest CDI infection rate in the United States. Participating institutions were almost exclusively teaching hospitals with more than 100 beds. Standardized clinical infection prevention and environmental cleaning protocols were adopted and monitored using checklists.
Outcomes for the program showed that it achieved a significant reduction in the incidence of hospital-onset CDI. Participating hospitals had 1,084 fewer cases of hospital-onset CDI than expected, with a total estimated cost savings of $2.7 million to $6.8 million. This reduction occurred without any interventions intended to alter antimicrobial prescribing practices and without adding extensive new resources.
"Interventions to interrupt and prevent C. diff transmission maybe more successful when implemented on a regional basis, which suggests that community and regional factors, including transferring patients between healthcare facilities, contributes to the epidemiology of C. diff and other healthcare-associated pathogens," said lead author Brian S. Koll, M.D., chief, infection prevention, Beth Israel Medical Center, New York.
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