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Analysis

3 Ways to Knock C. diff Rates Down to Zero

By Jennifer Thew RN  
   March 06, 2018

One hospital's multimodal approach has successfully lowered infections.

For Necia Kimber, RN, CIC, MHA, infection control practitioner at Stillwater (Oklahoma) Medical Center, "one infection is too many." Fortunately, when it comes to C. diff, Kimber has infection rates at the healthcare organization at just the right number: zero.

Thanks to a multifaceted approach, the 177-bed hospital with average daily census of 60 patients, has not seen a hospital-acquired case of C. diff since October 2017.

While the organization's rates were not above the national average, Kimber still wanted to reduce the bioburden—particularly of C. diff, MRSA, VRE, and CRE—within the hospital.

"We didn't have a high rate that made me say, ‘Oh, my goodness!' It was just wanting to do overall good and making sure we were doing the best we could," she says. "This is the hospital I'm going to bring my family to and I want to provide the best care for anybody who walks through that door."

Here are three ways Kimber achieved lower infection rates at Stillwater Medical Center:

1. Education

Kimber spearheaded an antimicrobial stewardship program at the facility in 2017. There was also assessment of and education regarding ordering of C. diff testing.

"[As healthcare professionals], when you have a patient and you can't find anything with normal testing, we tend to expound our testing," she says. "Sometimes it would end up hurting us with pay-for-performance—if [the patient] tested positive for [C. diff, it] didn't mean they were actually infected with it. They can just be colonized with it."

The infection control team provided education on national standards for ordering C. diff testing, including testing only when patients were symptomatic of the infection. The IC team provided nurses and physicians with education on when to implement C. diff precautions with the intent that earlier intervention would prevent transmission.

2. Hand hygiene and cleanliness

Hand hygiene was a focus area for preventing the spread of infections at Stillwater.

"We do a program that's a commitment to excellence," she says. "Last year we did a huge push on hand hygiene."   

Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.


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