Gut Reaction
The Hospitalist. 2011 December;2011(12):
December 1, 2011 | The Hospitalist
Those units with the best numbers are sometimes given a reward, such as a pizza party, but it’s colleagues’ knowledge of the numbers that matters most, she says.
“That, in and of itself, is a powerful motivator,” Dr. Scheurer says. “We bring it to all of our quality operations meetings, all the administrators, the CEO, the CMO. It’s very motivating for every unit. They don’t want to be the trailing unit.”
Tom Collins is a freelance medical writer based in Miami.
References
- Orenstein R, Aronhalt KC, McManus JE Jr., Fedraw LA. A targeted strategy to wipe out Clostridium difficile. Infect Control Hosp Epidemiol. 2011;32(11):1137-1139.
- Stevens V, Dumyati G, Fine LS, Fisher SG, van Wijngaarden E. Cumulative antibiotic exposures over time and the risk of Clostridium difficile infection. Clin Infect Dis. 2011;53(1):42-48.
What Hospitalists Can Do
Listen to Dr. Gould
Here are suggestions, as provided by ID experts and hospitalist leaders, on what hospitalists can do to battle C. diff infections:
Short-term steps:
- Wash hands before entering and upon leaving rooms occupied by patients with C. diff infections and those strongly suspected of having C. diff infections.
- Continue using alcohol-based hand sanitizers in addition to hand washing to prevent other types of outbreaks.
- Ensure that infected patients, and those suspected of being infected, are isolated, possibly even for 48 hours after diarrhea resolves, as research shows the patients can still transmit the spores.
- In units with high C. diff rates, consider universal gloving, not just for patients with known infection.
- Use more highly sensitive tests, such as polymerase chain reaction, or PCR, rather than enzyme immunoassays to more efficiently identify affected patients.
- Avoid testing patients with formed stools.
- Ensure that rooms of infected patients and patients strongly suspected of being infected are cleaned with a hypochlorite solution.
- Taper the use of broad-spectrum antibiotics in non-C. diff patients after test results are obtained.
- Encourage patients to question their healthcare practitioners about hand hygiene and use of antibiotics.
Long-term steps:
- Be involved with your hospital’s antimicrobial stewardship program.
- Conduct research into C. diff to explore its causes and treatments.
- Be a good role model for the rest of your group, emphasizing good practices and a strong patient-safety message.
