Using a nurse-initiated bedside tool to decrease inappropriate testing for Clostridioides difficile in hospital settings.

Autor:	Lenz A; Adventist Health Simi Valley, Simi Valley, CA, USA., Davis G; Adventist Health Simi Valley, Simi Valley, CA, USA., Asmar H; Adventist Health, Roseville, CA, USA., Nahapetian A; Adventist Health, Roseville, CA, USA., Dingilian J; Adventist Health Simi Valley, Simi Valley, CA, USA., Nathan RV; Adventist Health Simi Valley, Simi Valley, CA, USA.
Jazyk:	angličtina
Zdroj:	Journal of infection prevention [J Infect Prev] 2021 May; Vol. 22 (3), pp. 136-139. Date of Electronic Publication: 2020 Dec 09.
DOI:	10.1177/1757177420976815
Abstrakt:	Overdiagnosis of Clostridioides difficile ( C. difficile ) is associated with increased hospital length of stay, antibiotic overuse, unnecessary infection prevention efforts and excess costs. This study evaluated a paper-based bedside C. difficile screening tool on the number of C. difficile laboratory tests performed and number of C. difficile infection (CDI) diagnoses. Nurses used the tool to determine whether stool should be sent for C. difficile testing. The tool provided indications for stool testing. We collected data on the number of C. difficile stool tests performed and CDI diagnoses for nine months before (PreT) and after (PostT) tool implementation in the hospital. We found a 31% reduction in the mean monthly number of C. difficile tests performed (37 PreT to 25 PostT) and a 56% reduction in CDI diagnoses (19 PreT to 8 PostT). This study demonstrates the success of using nurses and a bedside tool to decrease inappropriate C. difficile testing. This intervention has implications for patient management, infection prevention and cost containment. This low-cost paper-based tool may be helpful for the 25% of hospitals in the USA not using clinical decision support in their electronic health record (EHR), as well as for hospitals outside the United States who may not have access to EHRs. Competing Interests: Declaration of conflicting interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: The last author is a member of Merck & Co., Inc., Allergan plc and The Medicines Co. speakers bureaus and has received speaker honoraria. (© The Author(s) 2020.)
Databáze:	MEDLINE
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