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Reduction in the Incidence of Clostridium difficile-Associated Diarrhea in an Acute Care Hospital and a Skilled Nursing Facility Following Replacement of Electronic Thermometers with Single-Use Disposables

Published online by Cambridge University Press:  21 June 2016

Steven E. Brooks
Affiliation:
Department of Laboratories, New York
Rebecca O. Veal
Affiliation:
Department of Laboratories, New York
Martin Kramer
Affiliation:
Infectious Disease, New York
Laura Dore
Affiliation:
Nursing, New York
Nicole Schupf
Affiliation:
Kingsbrook Jewish Medical Center, Brooklyn, and the Laboratory of Epidemiology, NYS. Institute for Basic Research in Developmental Disabilities, Staten Island, and the Gertrude H. Sergievsky Center, Columbia University School of Medicine, New York
Masasumi Adachi
Affiliation:
Department of Laboratories, New York

Abstract

Objective:

To determine if the spread of Clostridium difficile-associated diarrhea is related to the use of electronic thermometers in an acute hospital and a chronic healthcare facility.

Design:

After finding that a significant percentage (20.8%) of electronic rectal thermometer handles were contaminated with C difficile, all electronic thermometers were replaced with disposables. A before/after trial was conducted to determine if the change to disposable thermometers would reduce the incidence of C difficile-associated diarrhea.

Setting:

The study took place in a 343-bed acute hospital and a 538-bed skilled nursing facility.

Patients:

All patients who underwent routine microbiological evaluation for nosocomially acquired diarrhea over a l-year period were included in the study. Nosocomial diarrhea was defined as 3 or more loose stools per day for 2 consecutive days and/or abdominal findings such as pain, distention, and ileus occurring 3 or more days after admission.

Results:

During the 6-month postintervention period, the incidence of C difficile-associated diarrhea was reduced from 2.71/ 1,000 patient days to 1.76/ 1,000 patient days in the acute hospital and from 0.41/1,000 patient days to 0.1 1/1,000 patient days in the skilled nursing facility The protective effect of the intervention was statistically significant for both facilities.

Conclusions:

Replacement of electronic thermometers with single-use disposables significantly reduced the incidence of C difficile-associated diarrhea in both acute care and skilled nursing care facilities. Data suggest that the rectal route may be important in the transmission of C difficile in these settings.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1992

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Reduction in the Incidence of Clostridium difficile-Associated Diarrhea in an Acute Care Hospital and a Skilled Nursing Facility Following Replacement of Electronic Thermometers with Single-Use Disposables
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