1155. Excessive movement, unnecessary contamination: Clostridium difficile patients in the hospital
Session: Poster Abstract Session: Healthcare Epidemiology: Environmental and Occupational Health
Friday, October 5, 2018
Room: S Poster Hall
Background: The environmental contamination of Clostridium difficile in acute care hospital rooms is associated with increased risk of infection for subsequent patients. Patients that stay in a room following a patient with a C. difficile infection (CDI) have an increased risk of CDI compared to patients whose previous resident did not have CDI. The objective of this study was characterize the room movement of CDI patients in a Level 1 Trauma Medical Center.

Methods: A patient with CDI was defined as an inpatient with a positive C. difficile test through rapid serology, C. difficile polymerase chain reaction (PCR) or multiplex-stool PCR from March 2017 - March 2018. Patients were classified as either community-onset (CO, positive test < 4 days after admission) or hospital-onset (HO, positive test ≥ 4 days after admission). Additionally, the number of rooms each CDI patient resided in during one admission following a positive C. difficile test was determined and the proportion of patients who stayed in 1 – 2 rooms or at least 3 rooms per visit was calculated.

Results: There were a total of 244 CDI patients identified (172: CO, 72: HO) between March 2017 – March 2018. The mean time from admission to positive test was 12.4 hours post-admission for CO-CDI patients and 251.1 hours for HO-CDI patients. Almost 40% of HO-CDI patients (36.1%, n = 72) stayed in at least 3 rooms during their hospital admission compared to <30% of CO-CDI patients (28.4%, n = 172).

Conclusion: The current state of room movement with CDI patients is sub-optimal, resulting in increased infection risk for subsequent patients. A multi-faceted intervention to address this problem is essential to achieve an optimal goal of 1 – 2 rooms per hospital stay for a CDI patient. Quality improvement projects include (1) notification of patient movement to nursing leadership, (2) alerts to nursing supervisors of potential CDI patients before room transfer and (3) earlier diagnosis of community onset C. difficile.

Sara Reese, PhD, MPH, CIC, FAPIC1, Bryan Knepper, MPH, MS, CIC1, Amber Miller, MSN, RN, CIC, CSPDT1 and Heather Young, MD2, (1)Patient Safety and Quality, Denver Health Medical Center, Denver, CO, (2)Infectious Diseases, Denver Health Medical Center, Denver, CO

Disclosures:

S. Reese, None

B. Knepper, None

A. Miller, None

H. Young, None

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