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Test stewardship, frequency and fidelity: Impact on reported hospital-onset Clostridioides difficile

Published online by Cambridge University Press:  22 April 2019

Michele S. Fleming
Affiliation:
Healthcare Infection Prevention Program, Virginia Commonwealth University Health System, Richmond, Virginia
Olivia Hess
Affiliation:
Healthcare Infection Prevention Program, Virginia Commonwealth University Health System, Richmond, Virginia
Heather L. Albert
Affiliation:
Healthcare Infection Prevention Program, Virginia Commonwealth University Health System, Richmond, Virginia
Emily Styslinger
Affiliation:
Healthcare Infection Prevention Program, Virginia Commonwealth University Health System, Richmond, Virginia
Michelle Doll
Affiliation:
Healthcare Infection Prevention Program, Virginia Commonwealth University Health System, Richmond, Virginia
Huong Jane Nguyen
Affiliation:
Healthcare Infection Prevention Program, Virginia Commonwealth University Health System, Richmond, Virginia
Susan McAulay-Kidd
Affiliation:
Healthcare Infection Prevention Program, Virginia Commonwealth University Health System, Richmond, Virginia
Robin R. Hemphill
Affiliation:
Healthcare Infection Prevention Program, Virginia Commonwealth University Health System, Richmond, Virginia
Tara Srivastava
Affiliation:
Healthcare Infection Prevention Program, Virginia Commonwealth University Health System, Richmond, Virginia
Kaila D. Cooper
Affiliation:
Healthcare Infection Prevention Program, Virginia Commonwealth University Health System, Richmond, Virginia
Michael P. Stevens
Affiliation:
Healthcare Infection Prevention Program, Virginia Commonwealth University Health System, Richmond, Virginia
Gonzalo Bearman
Affiliation:
Healthcare Infection Prevention Program, Virginia Commonwealth University Health System, Richmond, Virginia
Corresponding

Abstract

We assessed the impact of an embedded electronic medical record decision-support matrix (Cerner software system) for the reduction of hospital-onset Clostridioides difficile. A critical review of 3,124 patients highlighted excessive testing frequency in an academic medical center and demonstrated the impact of decision support following a testing fidelity algorithm.

Type
Concise Communication
Copyright
© 2019 by The Society for Healthcare Epidemiology of America. All rights reserved. 

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References

Rock, C, Pana, Z, Leekha, S, et al. National healthcare safety network laboratory-identified Clostridium difficile event reporting: a need for diagnostic stewardship. Am J Infect Control 2018;46:456458.CrossRefGoogle ScholarPubMed
Madden, G, Weinstein, R, Sifri, C. Diagnostic stewardship for healthcare-associated infections: opportunities and challenges to safely reduce test use. Infect Control Hosp Epidemiol 2018;39:214218.CrossRefGoogle ScholarPubMed
Dubberke, E, Burnham, C. Diagnosis of Clostridium difficile infection treat the patient, not the test. JAMA Intern Med 2015;175:18011802.CrossRefGoogle Scholar
Madden, G, Mesner, I, Cox, H, et al. Reduced Clostridium difficile tests and laboratory-identified events with a computerized clinical decision support tool and financial incentive. Infect Control Hosp Epidemiol 2018;39:737740.CrossRefGoogle ScholarPubMed
Morgan, D, Malani, P, Diekema, D. Diagnostic stewardship: leveraging the laboratory to improve antimicrobial use. JAMA 2017;318:607608.CrossRefGoogle Scholar

Fleming et al. supplementary material

Fleming et al. supplementary material 1

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