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clinical nurse specialist,



  1. Pate, Kimberly MSN, RN, ACCNS-AG, PCCN
  2. Reece, Jennifer BSN, RN
  3. Smyre, Alex BCJ


Purpose/Objectives: The purpose of this project was to design and implement a sustainable program to reduce hospital-acquired cases of Clostridioides difficile.


Description of the Project: Experiencing higher rates in a large, academic medical center, hospital leaders were assembled. The overall facility rate was 6.9% in 2014 with a first quarter rate of 8.4% in 2015. Individual unit rates were as high as 19.8%. A team of key stakeholders was assembled to plan, execute, and reevaluate targeted solutions. Strategies implemented were an innovative, automated screening tool, an evidence-based prevention bundle; and staff education.


Outcomes: A facility-wide C difficile prevention program was implemented with a sustained decrease in rates observed from 8.4% in the first quarter of 2015 to 6.0% in the fourth quarter of 2017. The standardized infection ratio ranged from 0.541 to 0.889, consistently below the national mean.


Conclusion: Clostridioides difficile is a leading cause of hospital-associated diarrhea and a tremendous burden on healthcare systems increasing morbidity, mortality, and financial strain. A multidisciplinary, multifaceted approach was critical to ensure early detection, reduce risk of transmission, and decrease overall rates.