Background: CD rates are increasing, causing 14,000 deaths and $1
billion in healthcare spending annually (CDC, May 2015). This is
especially true in the high risk gynecologic oncology population. Appropriate
testing and use of contact precautions have proven efficacy. Staff
education may lead to improved adherence to isolation protocols and decrease
Methods: A CD educational module was administered to all
involved nurses and residents. Knowledge of correct protocol was tested
utilizing a pre-test/post-test design. All patients on the gynecologic oncology
service tested for CD were then prospectively followed for appropriate CD toxin
PCR and isolation orders, acceptance of orders, and PCR results. Historical
data on the above were collected from January 2012-July 2014 and analyzed using
the Fisher\'s exact test.
Results: Historically, 138 patients had CD PCR ordered.
Of these, none (0%) had appropriate isolation orders and 19/138 (1.4%) tested
positive. Fifty-three nurses and house staff were educated and surveyed, with a
pre and post test completion rate of 66%. Average post-test scores were 100%
amongst residents and 95% amongst nurses. Twenty-five post intervention CD PCRs
were ordered, of which 18/25 (72%) had isolation orders. Zero CD PCR tests were
positive. Compliance with precautions ( p < 0.0001) and CD infection
rates (p < 0.05) were significantly improved after undergoing the
Discussions: Use of a multi-disciplinary education module improves
adherence to CD isolation precautions and may decrease infection spread.
Keywords: C-difficile, gynecologic-oncology, compliance