Reduction of Clostridium difficile Infections After Implementation of Enteric Contact Precautions

The health system did not have an adequate process for notifying staff when a patient was on contact precautions due to Clostridium difficile (C. diff) infection as opposed to a different drug-resistant organism, such as methicillin-resistant Staphylococcus aureus. As a result, staff members were unaware that they should use soap and water rather than alcohol when performing hand hygiene after patient care and that they should use bleach disinfectant products to clean the environment and reusable equipment.

The health system's goal was to create a new isolation precaution specific to C. diff and other enteric infections that required the above infection control steps. The health system believed that using a separate isolation precaution would increase compliance and lower the current rate of hospital-acquired C. diff infections.

Two of the three hospitals within the system implemented a new isolation precaution called enteric contact precautions. Staff was educated on the new isolation precaution in staff meetings and through a series of announcements. Comparing baseline data from January 2013 through September 2014 to post-intervention data from October 2014 through April 2014, the health system decreased hospital-acquired C. diff infections by 50 percent.

This case study is part of the Illinois Health and Hospital Association's annual Quality Excellence Achievement Awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals and health systems in continually improving and transforming health care in the state. These organizations are improving health by striving to achieve the Triple Aim—improving the patient experience of care (including quality and satisfaction), improving the health of populations, and reducing the per capita cost of health care—and the Institute of Medicine's six aims for improvement—safe, effective, patient centered, timely, efficient, and equitable. To learn more, visit https://www.ihaqualityawards.org/javascript-ui/IHAQualityAward/