Description
Decrease inappropriate ordering
Decrease inappropriate samples sent to lab
With the above 2 goals met, will decrease over treating for someone with history of and not the actual infection.
Project Resources
Getting Physician Buy-in
Oral vancomycin prophylaxis for C. difficile
The Power of Poop: Updates in C. difficile infections
C.diff Guidelines
4 Moments of Stewardship
Patient Care Procedure – Endoscopy and Infectious Disease Clinic FECAL MICROBIOTA TRANSPLANTATION (FMT)
Duodenal Infusion of Donor Feces for Recurrent Clostridium difficile
Understanding Clostridium difficile Colonization
Epidemiology, Diagnosis, and Management of Clostridium difficile Infection in Patients with Inflammatory Bowel Disease
Core Elements
Action
Appointing a single leader responsible for program outcomes. Experience with successful programs show that a physician leader is effective.
Education
Educating clinicians about resistance and optimal prescribing.
Reporting
Regular reporting information on antibiotic use and resistance to doctors, nurses and relevant staff.
Tracking
Monitoring antibiotic prescribing and resistance patterns.
PDSA Cycles
Your organization has completed the following PDSA cycles. Click a heading to view a cycle's details.
Decreasing C. diff testing
Eliminating rejected stool samples
Decreasing ESBL both new and reoccurance
Decreasing treatment for asymptomatic bacturia
Decreasing positive C. diff results/ infections
IP Dashboard for the Clinic Quality Meeting to keep data in front of providers
Provider education on asymptomatic bactiuria
Provide the outylying providers with feedback r/t their performance and educate for improvement.
The C. diff results were reported up monthly. Case studies performed and reported up through AMS. Peer to peer discussion for any cases which was HO.
The overall number of C. diff ordered has decreased.
Efforts of the UW TASP DOH Flex ASB program decreased the over utilization of antibiotics. A direct correlation to decrease in ESBL and C. diff occurred. This was hoped for.
Plan to continue to report the C. diff cases and provide case studies at least through the end of the year 2022.
Educate the providers on:
1. WhidbeyHeatlh C. diff stats (total and breakdown of inhouse and clinic positive, negative, history of and specimen rejects. Provide the top reasons listed for testing the negative and rejected stools as documented in the patient’s charts.
2. WhidbeyHealth test of NAAT and what that means
3. Remind of best practices for ordering C. diff
IP to give research data to lab pathologist to present at a Med Staff meeting.
Created a Power Point presentation of the WhidbeyHealth data, best practices and expectations
Presented by Dr. Callahan at the All Providers meeting November 19th.
Continue to collect data and provide feedback.
No sustained change after the C. diff presentation.
Established an IP Dashboard for sustained feed back for the providers.
Dashboard include the data in graph form of test results broken down into neg and rejected specimens with comparision to positive.
Breakdown per provider for peer to peer comparison.
Reported the case studies and results individually to the outlyer providers.
Will continue to present the Dash Board. Included the ESBL new and reoccurance of ESBL related to overtreatment of asymptomatic bacteriuria.
Providing the outlying providers with feedback with education not to treat asymptomatic bacteriuria.
Continue with cycle 2 using the dashboard and adding formal trackable provider education.