CDI Prevention Protocols Maddeningly Inconsistent
One would think that with killer Clostridium difficile infections now at "historically high levels," acute care teams by now would have solid evidence-based knowledge of how to stop this intestinal nightmare from taking hold of their hospitals.
But then, as the saying goes, one would be wrong.
Results from a national survey of infection preventionists provide a rude wake-up jolt, and not just regarding how tough this problem is. Not only does C. difficile kill 14,000 patients a year in the U.S., but providers seem to be all over the map in their methods to attempt to annihilate this aptly named spore.
These practice differences are sure to be more obvious in coming months. As of January 1, the Centers for Medicare & Medicaid Services began requiring hospitals that want to continue receiving federal reimbursement to report their C. diff infection rates (CDIs) to the Centers for Disease Control and Prevention's National Healthcare Safety Network. Presumably, everyone will be watching what everyone else is doing.
In time, these rates will likely be publicly reported by hospital name. Some state laws already require it. And eventually the rates will probably become a measure of pay-for-performance for federal and private payers.
So there's a need to figure out what works and get infection control experts on the same page. But that just isn't happening. And the result is extremely frustrating.
Here's one example from the 26-question APIC survey, 78% of whose participants said they worked in acute care hospitals.
While 70% of those responding said their healthcare facilities had adopted additional interventions to control CDI, 24% had not and 6% didn't know. Of the 24% responding from facilities that had not adopted additional interventions, 55% said there were no plans for their organizations to adopt interventions in the next fiscal year.