In 2013, the facility's hospital-onset (HO) infection rate for Clostridium difficile (C. diff) had been trending upward over multiple quarters.
Despite implementing universal gloving, an increased emphasis on hand hygiene and antibiotic stewardship measures, the facility ended the year with a rate that was more than double its target. An interdisciplinary team consisting of the chief medical officer, the director of quality, the medical director for infection control, two infection preventionists and representatives from the pharmacy, housekeeping and nursing departments worked together to identify key areas for improvement.
The team devised an interdisciplinary bundle with an implementation goal of 90 days. The key components of the bundle were implemented throughout the first quarter of 2014; the bundle elements were dynamic and continuously refined over the next two quarters. During this time, the HO C. diff rate dropped 34 percent, and by the end of 2014, the facility achieved a 48 percent reduction in HO C. diff. First quarter 2015 data demonstrate a continued reduction in the incidence of C. diff with a sustained reduction of 54 percent over the last 15 months.