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Improved Adherence to C. Difficile Isolation Protocols Through Inter-disciplinary Education

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 infection rates.


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 educational module.


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

Topics: CREOG & APGO Annual Meeting, 2016, Resident, Faculty, Patient Care, Systems-Based Practice & Improvement, Practice-Based Learning & Improvement, CME, Quality & Safety, Team-Based Learning, Gynecologic Oncology,

General Information

Poster 2016 C & A Annual
Patient Care,Systems-Based Practice & Improvement,Practice-Based Learning & Improvement,
Quality & Safety,Team-Based Learning,
Clinical Focus
Gynecologic Oncology,

Author Information

Talati Asha, MD, University Hospitals Case Medical Center; Lobough-Jin Erica, BS; Kathleen Gonzalez, RN, BSN, MBA; Scott Sara, BSN, RN; Kimberly Gecsi, MD; Nakayama John, MD

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