1320. Enhanced Cleaning and Education to Prevent Transmission of Clostridium difficile in Pediatrics
Session: Poster Abstract Session: HAI: C. difficile Risk Assessment and Prevention
Friday, October 6, 2017
Room: Poster Hall CD
Posters
  • 1320_IDWPOSTER.jpg (699.7 kB)
  • Background: Transmission of healthcare-associated Clostridium difficile infection (HA-CDI) has been shown to occur directly or indirectly through a contaminated environment. At a tertiary-care cancer center, HA-CDI rates were higher for pediatric units than for other general oncology units. To address the problem, a multidisciplinary team, including Infection Control, Nursing, and Environmental Services (EVS), was convened and identified refusals and room clutter as barriers to proper cleaning of rooms on the unit.

    Aim: The aim of this study seeks to reduce HA-CDI in the inpatient pediatrics setting through environmental and educational interventions.

    Methods: In the first phase of the study from February - April 2016, a baseline assessment of prevalent environmental disinfection practices was made among Nursing, EVS, Physicians, and Patient Representatives. Based on this feedback, the following were implemented during Phase 2, from June through October 2016:  1) Unit-wide disinfection with bleach twice a day including common and high traffic areas; 2) Initiation of a “preferred time for cleaning” program to engage families; 3) Enhanced visitor and family education on PPE use; 4) Creation of a communication plan in case of refusal to clean rooms; and 5) Dedicated use of diaper scales.

    Results: During the first phase of the study, the following barriers to cleaning were identified: 1) High refusal rate as cleaning was perceived as inconvenient by families due to timing; 2) Common perception among EVS staff that multiple requests for cleaning the room may appear intrusive to the families; 3) Excessive clutter in the room; 4) Lack of education regarding PPE use; and 5) Shared equipment for diapers. To overcome these barriers, several interventions as outlined in methods were implemented. In Phase 2, there were 0 cases of HA-CDI identified in pediatric patients starting in July through October, 2016.

    Conclusion: Control of CDI on pediatric units poses unique challenges. Engagement of key stakeholders is essential to identify and meet these challenges and to devise effective strategies that will ultimately lead to reduced hospital-based transmission of CDI.

    Anoshé Aslam, MPH, Giselle Melendez, RN, EdD, Min Wang, BS, Frederic Stell, BS, Paulette Kelly, MSN, James Killinger, MD, Aimee Dannaoui, RN, Scott Riedman, BS, Ruben Lopez, LSSGB, Jill Ackerman, MBA, Alexander Chou, MD, Leonard Wexler, MD, David Smith, MSEd, Stacy Sanchez, RN, DNP, Elizabeth Robilotti, MD, MPH, Mini Kamboj, MD and Janet Eagan, RN, MPH, CIC, Memorial Sloan Kettering Cancer Center, New York, NY

    Disclosures:

    A. Aslam, None

    G. Melendez, None

    M. Wang, None

    F. Stell, None

    P. Kelly, None

    J. Killinger, None

    A. Dannaoui, None

    S. Riedman, None

    R. Lopez, None

    J. Ackerman, None

    A. Chou, None

    L. Wexler, None

    D. Smith, None

    S. Sanchez, None

    E. Robilotti, None

    M. Kamboj, None

    J. Eagan, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 4th with the exception of research findings presented at the IDWeek press conferences.