Cleaning Up C. Diff, Together

Marianne Aiello, for HealthLeaders Media , March 13, 2012
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The Hunterdon task force made an appeal to hospital administration for more cleaning staff after it determined how many additional high-touch surfaces needed to be cleaned in the patient environment.

"We did work studies identifying the time difference it would take, and we were successful in achieving those FTEs because we demonstrated the cost avoidance dollars by reducing infections and saving the institution money," Nash says. "Neither of our departments are revenue-generating, so we have to demonstrate avoidances costs."

Nash has since hired seven FTEs dedicated to C. diff preventive cleaning.

Testing high-touch surface cleanliness

To ensure that the new cleaning processes work, both Hunterdon and the Jewish Hospital use rapid-testing technology to determine if surface areas are up to their new standards. 

"We test high-touch surface areas and can get quick feedback on whether they were actually hitting everything," Wedig says. "The environmental services staff really bought into the whole need for doing this because they understood how important the cleaning was."

The C. diff task force at Hunterdon decided to start using an auditing tool to benchmark the effort's success, in addition to the decreasing incidence rates. The team had to justify the tool's expense to hospital administration, but it quickly became clear to all parties that the cost was worth it.

"The additional cost of the auditing tool is well warranted because it gives staff the confidence they're doing a good job," Nash says. "We found our staff is engaged in the process; they want to know how they're doing and they love the feedback. They get involved in actual testing itself, and it's a wonderful complete circle to the approach that will help get C. diff under control for any facility."

Since the height of Hunterdon's NAP1 outbreak in 2004, the hospital has seen an 80% decrease in c. diff cases and continues to see a decrease each year.

At the Jewish Hospital, the C. diff incidence rate was 21.1 per 10,000 patient days in March 2010, beating the goal of 22.74. By the summer of 2011, the rate had fallen to 3.08. 

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This article appears in the March 2012 issue of HealthLeaders magazine.

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