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Prevention program bested standard protocol, reduced C. difficile infections
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DALLAS — Compared with a standard cleaning protocol, a comprehensive prevention program decreased hospital acquired Clostridium difficile infections and associated costs, and increased patient satisfaction at a large, urban teaching hospital, according to a presenter here.
To fulfill the need for effective control measures for the increased incidence of hospital-acquired C. difficile infections, Michael Phillips, MD, of New York University Langone Medical Center, and colleagues created the Clean Team — a program aimed at disinfecting frequently touched surfaces in a hospital setting.
During the 6 month study period, the researchers disinfected patient rooms across five acute care units twice-daily. Cleaning performance was assessed in randomly selected rooms daily with real-time assay; feedback was immediately reported to the Clean Team staff. Hospital-acquired C. difficile infection rates in these units were then compared with the rates from 16 control units utilizing a standard cleaning protocol.
The rate for C. difficile infections decreased in all Clean Team units from 1.06 per 1,000 patient days to 0.76 per 1,000 patient days. Rates for C. difficile during the baseline and study period was 1.28 and 0.66 across Clean Team units compared with 0.94 and 0.82 across control units (P=.05).
Flouroquinolone use decreased from 86 days of therapy per 1,000 patient days at baseline to 64 days of therapy per 1,000 patient days across all units (P<.05). Further, an increase was observed in the number of patients in Clean Team units who reported their room as “always clean” (56% vs. 60%) vs. a slight decrease observed in the number of patients in control units (55% vs. 54%).
Length of stay in hospital-acquired C. difficile cases increased by a mean of 7.8 days and a median of 10.2 days; additional direct costs per hospital-acquired C. difficile infection were between $4,860 and $6,120, Phillips said.
“C. difficile is a significant nosocomial pathogen and in order to control it adequately requires a collaborative approach, which includes both antibiotic stewardship program, and also focusing on the environment and ensuring that items in the patient environment are systematically disinfected daily,” Phillips told Infectious Disease News. “Our focus on hand hygiene is appropriate and is needed, however, hand hygiene alone isn’t adequate hygiene. Health care workers in general really need to be focused on the patient environment, that includes equipment, and frequently touched surfaces within the patient room. A coordinated team approach is a key component.”– by Ashley DeNyse
Disclosures: Dr. Phillips reports no relevant financial disclosures.
For more information:
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Phillips M. #190. Presented at: SHEA 2011 Annual Scientific Meeting; April 1-4, 2011; Dallas.
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