What's in A Name? A Cluster of Hospital Epidemiologists

To the Editor—To paraphrase an African proverb, it takes a village to successfully reduce a healthcare facility’s rate of healthcare-associated infections.1 Most people are aware of terms used for common groups of animals such as a “pack” of dogs, “school” of fish, “flock” of birds, and “herd” of horses.2,3 Less common terms include a “scourge” of mosquitoes, a “parliament” of owls, a “crash” of rhinoceroses, a “dazzle” of zebras, a “murder” of crows, and a “tower” of giraffes.2,3 Collective terms for groups of humans have also been used such as a “hastiness” of cooks, a “stalk” of foresters, a “bevy” of ladies, and a “pity” of prisoners.

The compliance coach: A bedside observer, auditor, and educator as part of an infection prevention department's team approach for improving central line care and reducing central line-associated bloodstream infection risk

A compliance coach who audits central line maintenance and provides feedback and education to bedside nurses through timely, nonpunitive conversation is an effective addition to busy infection prevention departments. Staff nurses and nurse managers reported receiving clearly communicated and actionable information from the coach and compliance improved over time in multiple areas of central line maintenance

Preventable patient harm: A multidisciplinary, bundled approach to reducing clostridium difficile infections while using a glutamate dehydrogenase/toxin immunochromatographic assay/nucleic acid amplification test diagnostic algorithm

Health care facility-onset Clostridium difficile infections (HO-CDI) are an important national problem, causing increased morbidity and mortality. HO-CDI is an important metric for the Center for Medicare and Medicaid Service’s (CMS) performance measures. Hospitals that fall into the worst-performing quartile in preventing hospital-acquired infections, including HO-CDI, may lose millions of dollars in reimbursement. Under pressure to reduce CDI and without a clear optimal method for C. difficile detection, health care facilities are questioning how best to use highly sensitive nucleic acid amplification tests (NAATs) to aid in the diagnosis of CDI. Our institution has used a two-step glutamate dehydrogenase (GDH)/toxin immunochromatographic assay/NAAT algorithm since 2009. In 2016, our institution set an organizational goal to reduce our CDI rates by 10% by July 2017. We achieved a statistically significant reduction of 42.7% in our HO-CDI rate by forming a multidisciplinary group to implement and monitor eight key categories of infection prevention interventions over a period of 13 months. Notably, we achieved this reduction without modifying our laboratory algorithm. Significant reductions in CDI rates can be achieved without altering sensitive laboratory testing methods