Nurse-Driven C. difficile Protocol

Identifying Infections Earlier to Prevent Transmissions

Clostridium difficile (C. difficile) is a hearty bacterium that can be easily transmitted between patients if care is not taken to perform the proper hand hygiene and don personal protective equipment (PPE).

The C. difficile rate at Rush was exceeding the organizational goal and, along with conducting an in-depth analysis, an interprofessional team, including infection prevention, unit staff and leadership, began looking for solutions.

The team determined that there was potential to identify patients with C. difficile earlier in their inpatient stay by leveraging technology. Through collaboration with the Information Services Division and nursing leaders, an Epic best practice alert was linked to the ordering process in support of the C. difficile nurse-driven protocol.

The best practice alert mines key elements of nursing documentation from Epic and alerts the nurse if a patient meets the criteria for C. difficile testing within the first three days of their inpatient stay. Once alerted, the nurse is empowered to make an independent decision to order testing for C. difficile, based on the evaluation of the patient.

This process, initiated in the beginning of April 2016, resulted in an increased number of C. difficile cases being detected within the first three days of a patient’s stay.

Earlier identification of patients with C. difficile has led to several improvements, including the following:

  • Earlier treatment for patients
  • Initiation of isolation-based precautions at an earlier stage to prevent the potential transmission between patients through contaminated health care workers or the environment
  • More accurate public reporting of healthcare-associated C. difficile cases

This initiative supports Rush University Medical Center’s mission to provide the very best patient care.Clostridium Diciffile nursing chart.

Nurse-Led Rounds