AIMS: 
To analyze CDI patterns to TJUH, particularly in Opportunity Units
To visually examine the relationship between CDI cases within units
Provide data analysis to the CDI working grouphttps://jdc.jefferson.edu/patientsafetyposters/1072/thumbnail.jp

Cowan, MD, Scott W.

Flomenberg, MD, Phyllis

Nandra, MD, Kulvir

Tseng, Andrew

Zabriskie, Kelly

English

Jefferson Digital Commons

Thomas Jefferson UniversityJefferson Digital CommonsHouse Staff Quality Improvement and PatientSafety Posters GME Quality and Safety5-31-2017Analysis of Clostridium difficile patterns at ThomasJefferson University HospitalAndrew TsengJefferson College of Population Health, andrew.tseng@jefferson.eduKulvir Nandra, MDThomas Jefferson University, kulvir.nandra@jefferson.eduKelly ZabriskieThomas Jefferson University, kelly.zabriskie@jefferson.eduPhyllis Flomenberg, MDDepartment of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, Phyllis.Flomenberg@jefferson.eduScott W. Cowan, MDThomas Jefferson University, Scott.Cowan@jefferson.eduFollow this and additional works at: http://jdc.jefferson.edu/patientsafetypostersPart of the Medicine and Health Sciences CommonsLet us know how access to this document benefits youThis Article is brought to you for free and open access by the Jefferson Digital Commons. The Jefferson Digital Commons is a service of ThomasJefferson University's Center for Teaching and Learning (CTL). The Commons is a showcase for Jefferson books and journals, peer-reviewed scholarlypublications, unique historical collections from the University archives, and teaching tools. The Jefferson Digital Commons allows researchers andinterested readers anywhere in the world to learn about and keep up to date with Jefferson scholarship. This article has been accepted for inclusion inHouse Staff Quality Improvement and Patient Safety Posters by an authorized administrator of the Jefferson Digital Commons. For more information,please contact: JeffersonDigitalCommons@jefferson.edu.Recommended CitationTseng, Andrew; Nandra, MD, Kulvir; Zabriskie, Kelly; Flomenberg, MD, Phyllis; and Cowan, MD, Scott W., "Analysis of Clostridiumdifficile patterns at Thomas Jefferson University Hospital" (2017). House Staff Quality Improvement and Patient Safety Posters. Poster 36.http://jdc.jefferson.edu/patientsafetyposters/36Background • Clostridium difficile infection (CDI) is a healthcare-associated infection (HAI) associated with about half a million infections a year in the U.S1.  • In 2011, 29,000 people died within 30 days off CDI diagnosis1.  • Age > 65 , antibiotics, and nursing homes residence  stay increase the risk of  C. difficile infections1.  • C. difficile infections negatively impact patient outcomes and hospital reimbursement.  • A clear understanding  of temporal and spatial relationships of CDI cases at  Thomas Jefferson University  Hospitals  is lacking. Recent Performance We analyzed and reviewed  CDI data collected by infection control between March 2015  and September 2016 and identified “Opportunity Units” that could benefit  from intervention. Heat Mapping an “Opportunity Unit” Aims  • To analyze  CDI patterns at  TJUH, particularly in Opportunity Units • To visually examine the relationship between CDI cases within units • Provide  data analysis to the CDI working group  Proposed Interventions • Establish a screening program in high risk unit patients • Reassess terminal cleaning protocol of the room and equipment • Improve communication of patient CDI status to family members • Earlier testing of patient at the first sign of loose stool in all units • Track  antibiotic usage, especially in the high risk units Limitations • The study population included CDI patients only. Further studies may include case control studies in patients without CDI • Bed transfers between and within units were not included in the analysis • Hospital floors have different turnover rates and different patient populations  • Patients on antibiotics are at increased risk of having a CDI2. Further analyses which incorporate risk factors for CDI (antibiotic use, age, nursing home stay) are warranted Analysis of Clostridium difficile patterns at Thomas Jefferson University Hospital  Andrew Tseng1; Kulvir Nandra, MD2; Kelly Zabriskie3; Phyllis Flomenberg, MD3, Scott Cowan, MD2 1Jefferson College of Population Health 2Department of Surgery, Thomas Jefferson University, Sidney Kimmel Medical College 3Infection Control, Thomas Jefferson University Hospital  References 1. Centers for Disease Control and Prevention. (n.d.). Deadly Diarrhea: C. Difficile causes immense suffering, death. 2. Brown, K., Khanafer, N., Daneman, N., Fisman, D.(2013). Meta-analysis of Antibiotics and the Risk of Community-Associated C. difficile infection. Antimicrobial Agents and Chemotherapy, 57(5).  0102030405060Number of cases HO & CO Cases by Month COHO05101520253035404550Number of Cases All Cases from March 2015 to September 2016 Further Analysis • Huddles and changes were initiated in May 2016. Further analyses including pattern assessments may define additional opportunities for improvement • Perform root cause analysis on opportunity units and provide feedback to front line providers • Observe healthcare provider hand hygiene and PPE compliance to understand correlations between CDI within units and hygiene protocol adherence Figure 1. C. difficile cases by month  separated by hospital onset (HO) and community onset (CO).  Figure 2. All C. difficile cases by units from March 2015 to September 2016. Figure 3.  Floor plans of 3 West showing cases that occurred within 30 days of a prior case.  Table 1 . Hospital beds with subsequent HO infections within 60 days after an onset case of HO/CO infection. Table 2 . Hospital units with subsequent HO infections within 30 days after an onset case of HO/CO infection in Gibbon. 

Analysis of Clostridium difficile patterns at Thomas Jefferson University Hospital

AIMS: 
To analyze CDI patterns to TJUH, particularly in Opportunity Units
To visually examine the relationship between CDI cases within units
Provide data analysis to the CDI working grouphttp://jdc.jefferson.edu/patientsafetyposters/1072/thumbnail.jp

Name not available

https://jdc.jefferson.edu/cgi/viewcontent.cgi?article=1072&amp;context=patientsafetyposters

Analysis of Clostridium difficile patterns at Thomas Jefferson University Hospital

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