Use of a Launderable Bed Barrier and Antibiotic Stewardship to Decrease Hospital Onset Clostridioides difficile Infections in an Acute Care Hospital: A Retrospective Pre-Post Case Study.

Journal of Health Economics and Outcomes Research
Edmond A HookerFrancisco Fernandez Gonzales

Abstract

Hospital-onset Clostridioides difficile infection (HO-CDI) is a major source of morbidity and mortality. The objective of this research was to evaluate the reduction in HO-CDI through the use of a launderable bed barrier (BB) and an antibiotic stewardship program (ASP). A retrospective pre-post study was conducted at an acute care hospital in Kentucky. The preintervention period was September 2014 through March 2016. The BB and the ASP were introduced in April 2016, and the post-intervention period for this study ended September 2018. The rate of HO-CDI was calculated from the actual number of HO-CDI divided by the number of patient days each month. The number of defined daily doses of antibiotic therapy was measured each quarter. Hand disinfection compliance, length-of-stay (LOS), case mix index (CMI), and average age of patients were collected to control for confounding in the regression models. There were 34 HO-CDIs and 42 672 patient days in the pre-intervention period and 31 HO-CDIs and 65 882 patient days in the post-intervention period. The average monthly count of HO-CDI was 1.79 (SD 1.51) and 1.03 (SD 0.96) during the pre- and post-periods, respectively. The average monthly rate (per 10 000 patient-days) was 7.94 (SD 6...Continue Reading

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