Environmental services impact on healthcare-associated Clostridium difficile reduction

Healthcare-associated Clostridium difficile infection (CDI) can result from organisms found on hospital environmental surfaces. Without proper cleaning of hospital environmental surfaces, cross-contamination can occur, resulting in a healthcare-associated infection. In 2011, an environmental services (EVS) model was developed in Hospital A that resulted in a reduction in healthcare-associated CDI. The purpose of this study was to determine if implementing Hospital A's EVS model in Hospital B would decrease healthcare-associated CDI incidence.

A quasi-experimental design was used. The study was conducted in Hospital B, a 53-bed acute care community-based hospital, between January 2013 and December 2017. A retrospective review of all CDI LabID A/B toxin enzyme immunoassay events was performed using the National Healthcare Safety Network surveillance definitions. The data were calculated based on incidence rates per 1,000 patient days and the National Healthcare Safety Network standard infection ratio formula. No new disinfectants, antibiotic restrictions, or new isolation techniques were instituted during this time period.

There was a 100% reduction in healthcare-associated CDI in Hospital B from 2013's baseline rate of 0.48 per 1,000 patient days to 0.00 per 1,000 patient days (0.48, 0.00, P = 0.020).

This study highlights the importance of EVS education and accountability as well as recognition of the role played by EVS in reducing healthcare-associated CDI within healthcare facilities.