Other Healthcare Associated Infections Measures



Clostridium Difficile Intestinal Infections

What are we measuring and why?

Healthcare associated infections (HAI) are infections that patients acquire while receiving medical treatment in a healthcare facility. These infections are often harmful and costly to treat, but can usually be prevented through the use of proper precautions and infection control practices. The Centers for Medicare and Medicaid Services (CMS) publishes hospital HAI results, which are increasingly used to assess the quality and safety of patient care. Data are reported as a standardized infection ratio (SIR), which compares a hospital’s observed number of infections to its predicted number of infections, after adjusting for institutional characteristics known to cause differences in incidence. A lower SIR is better, with the ultimate goal of zero infections.

How are we doing and how do we compare to best practice?

Clostridium Difficile (C. diff) is a type of bacteria that can cause diarrheal illness and colon inflammation. It is associated with antibiotic treatment; long-term use of such medications can disrupt the normal intestinal flora, thus making patients more susceptible to an overgrowth of C. diff bacteria. It produces spores that can survive outside the human body for an extended period of time. In healthcare settings, C. diff is often spread through contact with contaminated surfaces; therefore, it is important that hospital staff take appropriate precautions, such as proper hand hygiene practices, to reduce the transmission of C. diff.

Publicly reported hospital-onset C. diff events are identified through laboratory testing and defined as C. diff-positive stool samples collected four or more days after inpatient admission. In 2017, MGH’s C. diff SIR (0.90) was statistically similar to the national benchmark (1.0). This captures all inpatient locations except well baby nurseries/clinics and the neonatal ICU.

  • Current Scores
  • Scores Over Time
  • Lower values are better
0.81 0.9

MGH Source: National Healthcare Safety Network
Comparison Group Source: CMS Hospital Compare

MGH: Jan - Dec 2017
CMS: Jan - Dec 2017

1.14 0.98 0.9 1 0.92 0.81

MGH Source: National Healthcare Safety Network
Comparison Group Source: CMS Hospital Compare



What are we doing to improve?

Reducing hospital-acquired C. diff infections is an institutional priority at MGH. The key to limiting its transmission is to consistently follow Infection Control protocols for Contact Precautions Plus, which require all employees to wear gowns and gloves while providing care to known or suspected C. diff patients. Once finished and before exiting a patient’s room, employees are required to wash their hands with soap and water followed by Cal Stat (an alcohol-based hand rub). Increased focus on hand hygiene, environmental cleanliness, and appropriate testing over the past three years has led to a substantial reduction in the number hospital-acquired C. diff cases at MGH.

 

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