Dramatically reducing C. difficile with best practices and leadership
Azalea Wedig, BS, CIC
The Jewish Hospital – Mercy Health
When daily surveillance revealed an increasing rate of Clostridium difficile (C. difficile) at her 200-bed hospital in 2009, Azalea Wedig, BS, CIC, immediately jumped into action. A microbiologist who transitioned to infection prevention after personal experience with a healthcare-associated infection (HAI), Wedig is particularly adept at connecting the science of infection prevention to the people most deeply affected and involved.
Wedig’s first step was to form a cross-disciplinary C. difficile performance improvement team. After a thorough review of literature, data, and existing guidelines, the team agreed to focus on three areas: environmental services, antibiotic stewardship, and standardization of clinical care. They committed to reduce their hospital’s C. difficile incidence rate by 10 percent for the first quarter of 2010.
“We didn’t do anything new,” said Wedig. “We didn’t reinvent wheels. We used science, best practices and team work.”
Wedig and her team members systematically identified specific environmental, pharmacy, and clinical practice behaviors that were contributing to the hospital’s C. difficile rates, and then worked to change them. Ongoing education and engagement of staff, patients, visitors, and volunteers played a significant role.
Within six months, the Jewish Hospital C. difficile rate had dropped from 33.3 per 10,000 patient days to 15.8. By June 2011, the rate had fallen to 3.08— half the statewide incidence rate.
“Our hospital succeeded because we worked as a team,” said Wedig. “Infection prevention became everyone’s business. Empowerment and encouragement were key.”
Over the past three years, the team has sustained the lower C. difficile rate through staff education and recognition programs, including an annual, hospital-wide infection prevention award.
“You have to make everyone in the facility feel like part of the infection prevention team,” said Wedig.