Using a nurse-initiated bedside tool to decrease inappropriate testing for Clostridioides difficile in hospital...

Area of Science:

• Infectious Diseases
• Hospital Administration
• Clinical Diagnostics

Background:

• Overdiagnosis of Clostridioides difficile (C. difficile) infection leads to increased hospital stays, antibiotic overuse, and higher costs.
• Current diagnostic practices may contribute to unnecessary laboratory testing and patient management challenges.

Purpose of the Study:

• To evaluate the impact of a paper-based bedside screening tool on C. difficile laboratory testing and diagnosis rates.
• To assess the effectiveness of nurse-led C. difficile screening in reducing inappropriate testing.

Main Methods:

• A paper-based bedside screening tool was implemented for nurses to guide C. difficile stool testing decisions.
• Data on C. difficile stool tests and diagnoses were collected for nine months before and after tool implementation.

Main Results:

• A 31% reduction in the mean monthly number of C. difficile tests performed was observed post-implementation (37 to 25).
• A 56% reduction in C. difficile infection diagnoses occurred after tool implementation (19 to 8).

Conclusions:

• The bedside screening tool successfully decreased inappropriate C. difficile testing and diagnoses when used by nurses.
• This low-cost intervention offers significant implications for patient management, infection control, and cost containment, particularly for institutions without EHR decision support.