262061 Reducing C. diff in inpatient settings; a comprehensive policy analysis

Monday, October 29, 2012

Logan Cowan, MPH(c) , Health Science, Brigham Young University, Provo, UT
Riley Hedin, MPH(c) , Health Science, Brigham Young University, Provo, UT
Erik Linton, MPH(c) , Health Science, Brigham Young University, Provo, UT
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.

Learning Areas:
Administer health education strategies, interventions and programs
Administration, management, leadership
Protection of the public in relation to communicable diseases including prevention or control
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy

Learning Objectives:
Define Clostridium difficile infection (CDI) Quantify the CDI problem in the United States Differentiate the roles that various stakeholders play in the implementation process Identify advantages to a comprehensive policy approach vs individual policies Identify CDI reduction best practices for inpatient environments Compare implementation of best practices across inpatient settings Evaluate the overall effectiveness of the implementation process

Keywords: Health Care Quality, Public Health Policy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I participated in the research and co-authored the paper with my colleagues. I am actively pursuing a graduate degree in public health and have other research under review at peer reviewed journals.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.