Does clinician-initiated Clostridioides difficile testing improve outcomes of patients with Clostridioides Difficile infection?
Hospital policies
Hospital policy change
Hospital-acquired infection control
Ordering time
Stool samples
Journal
American journal of infection control
ISSN: 1527-3296
Titre abrégé: Am J Infect Control
Pays: United States
ID NLM: 8004854
Informations de publication
Date de publication:
10 2023
10 2023
Historique:
received:
17
11
2022
revised:
24
02
2023
accepted:
26
02
2023
medline:
3
10
2023
pubmed:
28
9
2023
entrez:
27
9
2023
Statut:
ppublish
Résumé
Clostridioides difficile (C. difficile) is a common hospital-acquired infection which can lead to major implications for patients and our health care system. In this study, we examine a policy change at a single-site Veterans Affairs Healthcare system that allowed bedside nurses to order C. difficile testing in addition to physicians on the time to obtain test results and initiate treatment. The time to receive results and initiate treatment were analyzed before and after the policy change, and between physicians and nurses using descriptive statistics and paired student t-tests. Variables associated with lower ordering times were also analyzed using logistic regression while adjusting for patient admission location and length of inpatient hospital stay. The difference in time to obtain the result both before and after the policy change and between ordering provider type were both statistically significant (P < .05). In unadjusted models, nurses were associated with faster test results compared to physicians (OR (95% CI) 1.72 (1.45-2.05). Allowing bedside nurses more autonomy to order the stool sample significantly decreased the amount of time to receive the results, potentially decreasing the risk of additional infections among patients and decreasing the economic burden on the hospital.
Sections du résumé
BACKGROUND
Clostridioides difficile (C. difficile) is a common hospital-acquired infection which can lead to major implications for patients and our health care system. In this study, we examine a policy change at a single-site Veterans Affairs Healthcare system that allowed bedside nurses to order C. difficile testing in addition to physicians on the time to obtain test results and initiate treatment.
METHODS
The time to receive results and initiate treatment were analyzed before and after the policy change, and between physicians and nurses using descriptive statistics and paired student t-tests. Variables associated with lower ordering times were also analyzed using logistic regression while adjusting for patient admission location and length of inpatient hospital stay.
RESULTS
The difference in time to obtain the result both before and after the policy change and between ordering provider type were both statistically significant (P < .05). In unadjusted models, nurses were associated with faster test results compared to physicians (OR (95% CI) 1.72 (1.45-2.05).
CONCLUSIONS
Allowing bedside nurses more autonomy to order the stool sample significantly decreased the amount of time to receive the results, potentially decreasing the risk of additional infections among patients and decreasing the economic burden on the hospital.
Identifiants
pubmed: 37758340
pii: S0196-6553(23)00100-1
doi: 10.1016/j.ajic.2023.02.017
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1085-1088Informations de copyright
Published by Elsevier Inc.