Reducing C. diff in inpatient settings; a comprehensive policy analysis

Approximately 1 out of every 20 inpatients in the United States contracts a healthcare associated infection (HAI), the most common of which is Clostridium difficile (C. diff). Over the past 30 years, Clostridium difficile infection (CDI) has become a major threat in inpatient healthcare settings, such as hospitals. The cost per day for CDI patients throughout the U.S. deduces to between $17.6 million and $51.5 million. CDI may result from exposure to antibiotics, gastrointestinal surgery or manipulation, lengthy stay in healthcare settings, serious underlying illness, immunodeficiency, and older age. This analysis suggests comprehensive policy bundles as the approach to reducing C. diff because it more effectively addresses the interests of valued healthcare organizations and stakeholders. Four hospital case studies were selected that reflect a comprehensive approach using four areas of prevention (hand hygiene, environmental sanitation, patient isolation, and antibiotic stewardship) to reduce C. diff. In order to compare the effectiveness of each of the selected hospitals' comprehensive policies, a rubric was created to score each hospital on the four key areas included in comprehensive C. diff reduction policies. Of the four case studies, the comprehensive approach used by the St. Joseph Health Center and St. Joseph Hospital West scored the highest in the analysis and the methods used are scalable to most inpatient facilities. It is suggested that a standard be set that encourages inpatient care facilities to implement policies using a SJHC and SJHW as a model system.