Clostridium difficile Infections (CDI): Opportunities for Prevention. Linda Savage, RN, BSN, CDONA/LTC QI Specialist, Telligen March 23, 2016
|
|
- Andra Mason
- 6 years ago
- Views:
Transcription
1 Clostridium difficile Infections (CDI): Opportunities for Prevention Christine LaRocca, MD Medical Director, Telligen Linda Savage, RN, BSN, CDONA/LTC QI Specialist, Telligen March 23, 2016 Deanna Curry, MS, RN QI Manager, Telligen
2 Presentation Objectives Introduction to Telligen and current infection prevention projects with hospitals and nursing homes Review CMS quality strategy and focus on CDI Discuss the impact of CDI on patients (a CDI patient story) Focus on CDI sign and symptoms, appropriate testing and overview of prevention guidelines Review of National Healthcare Safety Network (NHSN) Healthcare-Associated Infections (HAI) resources for Long-Term Care (LTC) and the new CDI opportunity for LTC with Telligen and our state partners 2
3 Pop Quiz 3 In 2011, how many CDI-associated deaths occurred in the U.S.? A. 52,000 B. 29,000 C. 14,000 D. 7,000 Lessa FC, et al. Burden of Clostridium difficile Infection in the United States. N Engl J Med 2015; 372;9:
4 CDI by the Numbers- US Burden in ,000 CDI cases 29,300 deaths 4 83,000 (18%) first CDI recurrence Lessa FC et al. N Engl J Med 2015;372:
5 Who is Telligen? What is the QIN-QIO Program? Telligen: The Medicare Quality Innovation Network (QIN)-Quality Improvement Organization (QIO) for Colorado, Iowa and Illinois QIN-QIO Program Purpose: To improve the efficiency, effectiveness, economy, and quality of services delivered to Medicare beneficiaries 5
6 Who is Telligen? What is the QIN-QIO Program? QIN-QIOs have performance-based contracts with the Centers for Medicare & Medicaid Services (CMS) Results are measured by CMS QIN-QIOs help achieve national quality goals through focused efforts at the community level 6
7 CMS Quality Strategy Foundational Principles 1. Enable innovation 2. Foster learning organizations 3. Eliminate disparities 4. Strengthen infrastructure and 7 data systems Goals 1. Make care safer 2. Strengthen person and family centered care 3. Promote effective communications and care coordination 4. Promote effective prevention and treatment 5. Promote best practices for healthy living 6. Make care affordable 7
8 QIN- QIOs : What do we do? Champion local-level, results-oriented change Data driven, collecting and analyzing data for improvement Active engagement of patients and other partners Proactive, intentional innovation and spread of best practices Facilitate learning and action networks Creating an all teach, all learn environment Placing impetus for improvement at the bedside level e.g. hand washing Provide communities with technical assistance Consultation, education, resources, tools at no cost to support healthcare quality improvement at the community level 8
9 Overview of QIN-QIO Contract Tasks Improving Care Coordination and Reducing Adverse Drug Events Improving Cardiac Health and Reducing Healthcare Disparities Reducing Disparities in Diabetes Care: Everyone with Diabetes Counts (EDC) Improving Prevention Coordination through Meaningful Use of HIT and Collaborating with Regional Extension Centers Reducing Healthcare-Associated Infections (HAI) in Hospitals Reducing Healthcare-Acquired Conditions (HACs) in Nursing Homes 9
10 Nursing Homes and Hospitals Share Patients and Infections! 66% of NH residents who developed CDI were recently discharged from hospital Nursing home 26% of NH residents with CDI hospitalized Hospital Rochester Emerging Infection Program 10 surveillance data credit Dr. Ghinwa Dumyati for slide 35% of CDI patients discharged to NH
11 11
12 The National Landscape: Focusing on CDI Prevention is Timely The Skilled Nursing Facility Value-Based Purchasing Program 30-Day All-Cause Readmission Measure (SNFRM) (NQF #2510) and recall that CDI doubles chances of readmission Proposed Rule: Medicare and Medicaid Programs; Reform of Requirements for Long-Term Care Facilities. Infection Control ( ) Infection Prevention and Control Program Infection Prevention and Control Officer ( (b)) CMS Accountable Care Organizations (ACOs) Readmissions is a Quality Measure 12
13 Reducing Healthcare-Associated Infections (HAIs) in Hospitals 23 Colorado hospitals have joined HAI Reduction Collaborative Eight critical access hospitals Four rural hospitals Strong collaborations with Colorado Hospital Association, Colorado Department of Public Health & Environment, Colorado Rural Healthcare Association and Colorado Health Care Association 13
14 Reducing Healthcare-Associated Infections (HAIs) in Hospitals Definitions Central Line-Associated Bloodstream Infection (CLABSI) Catheter-Associated Urinary Tract Infection (CAUTI) Clostridium difficile Infection (CDI) Standard Infection Ratio (SIR) a summary measure to track HAIs 14
15 Reducing Healthcare-Associated Infections (HAIs) in Hospitals Goals Participating hospitals meet or exceed the current national benchmarks (SIRs) for CLABSI, CAUTI, CDI, and device utilization (Foley catheters) by October 31,
16 Shirley s Story: A CDI Patient Story This short video depicts a case of a recurring CDI, leaving a patient wondering: "Will I ever fully recover? A2OpniaYn4Gf5RL3X6NkHfdvoUzhDat&index=4 16
17 Clostridium difficile Infections (CDI) CDI a spore-forming, gram-positive bacterium that releases two potent toxins, toxin A and toxin B These toxins bind to certain receptors in the lining of the colon and cause diarrhea and inflammation of the large intestine One possible explanation for increase in CDI is a newer strain of CDI produces as much as 20 times more toxin A and toxin B 17
18 Clostridium difficile Infections (CDI) The incidence of Clostridium difficile infection (CDI) has risen almost 3-fold in the United States over the past decade, emphasizing the need for rapid and accurate tests for CDI. Novak-Weekley, SM Clostridium difficile Testing in the Clinical Laboratory by Use of Multiple Testing Algorithms. J. Clin. Microbiol. Journal of Clinical Microbiology, 48(3),
19 CDI Signs and Symptoms Mild to Moderate Infection Watery diarrhea three or more times a day for two or more days Mild abdominal cramping and tenderness Severe Infection Watery diarrhea 10 to 15 times a day Abdominal cramping and pain, which may be severe Fever, Blood or pus in the stool, Nausea Dehydration, Loss of appetite, Weight loss Swollen abdomen, Kidney failure Increased white blood cell count 19
20 CDI Infections Asymptomatic infection - patient/resident is showing no signs or symptoms of the infection Symptomatic (active) infection patient/resident is showing signs and symptoms of the infection 20
21 Diagnosis of Clostridium difficile Infection Treat the Patient, Not the Test No laboratory test can diagnosis Clostridium difficile infection (CDI) CDI is a clinical diagnosis that can be supported by laboratory data. While a diagnostic assay may indicate the absence or presence of the organism or its toxins, the test by itself does not determine who does or does not have CDI Dubberke, E. R., & Burnham, C. D. (2015). Diagnosis of Clostridium difficile Infection. JAMA Internal Medicine JAMA Intern Med, 175(11),
22 CDI Clinical Laboratory Testing Methods Enzyme immunoassay (EIA). detects the presence of C. diff toxins A and B in stool. It is important to recognize that the performance of immunoassays can vary widely by product and can also be affected by protocol deviations or improper technique or specimen handling. Glutamate dehydrogenase (GDH). This assay detects the presence of the enzyme, glutamate dehydrogenase (GDH), which is produced by all C. difficile organisms. GDH is also produced by other bacteria. All positive antigen results must be combined with a toxin test to confirm the presence of C. difficile toxin. Cell cytotoxicity assay. This type of test is sensitive, but it is less widely available, more cumbersome to do and requires more than 24 to 48 hours for test results. Some facilities use both the EIA test and cell cytotoxicity assay to ensure accurate results. Polymerase chain reaction (PCR). This sensitive molecular test can rapidly detect the C. difficile toxin B gene in a stool sample and is highly accurate. Testing for CDI is unnecessary if patient is not having diarrhea or watery stools. 22
23 CDI Testing Methods in the Clinical Laboratory Parameters EIA Only GDH + EIA GDH + EIA + cytotoxin GDH + PCR PCR No. of Specimens Sensitivity 58.3% 55.6% 83.1% 86.1% 94.4% Specificity 94.7% 98.3% 96.7% 97.8% 96.3% Accuracy 88.7% 91.2% 94.4% 95.8% 96% PPV 68.9% 87% 83.1% 88.6% 84% NPV 91.9% 91.7% 96.7% 97.2% 98.8% EIA, enzyme immunoassay; GDH, glutamate dehydrogenase; PCR, polymerase chain reaction; PPV, positive predictive value; NPV, negative predictive value Novak-Weekley, SM Clostridium difficile Testing in the Clinical Laboratory by Use of Multiple Testing Algorithms. J. Clin. Microbiol. Journal of Clinical Microbiology, 48(3),
24 24 This material was prepared by the Lake Superior Quality Innovation Network, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The materials do not necessarily reflect CMS policy. 11SOW-MI/MN/WI-C
25 Guidelines for Diagnosis, Treatment and Prevention of Clostridium difficile Infections American College of Gastroenterology Only stools from patients with diarrhea should be tested for Clostridium difficile Repeat testing should be discouraged Testing for cure should not be done Routine screening for C. difficile in hospitalized patients without diarrhea is not recommended and asymptomatic carriers should not be treated Antibiotic stewardship is recommended to reduce the risk of CDI Contact precautions for a patient with CDI should be maintained at a minimum until the resolution of diarrhea See link below for full list of recommendations Am J Gastroenterol 2013; 108: ; doi: /ajg ; published online 26 February
26 Guidelines for Diagnosis, Treatment and Prevention of Clostridium difficile Infections American College of Gastroenterology Patients with known or suspected CDI should be placed in a private room or in a room with another patient with documented CDI Hand hygiene and barrier precautions, including gloves and gowns, should be used by all health-care workers and visitors entering the room of any patient with known or suspected CDI Disinfection of environmental surfaces is recommended using an Environmental Protective Agency (EPA)-registered disinfectant with C. difficile-sporicidal label claim or 5000 p.p.m. chlorinecontaining cleaning agents in areas of potential contamination by C. difficile See link below for full list of recommendations Am J Gastroenterol 2013; 108: ; doi: /ajg ; published online 26 February
27 CDI Prevention for Healthcare Providers Prescribe and use antibiotics carefully. Once culture results are available, check whether the prescribed antibiotics are correct and necessary Order a C. difficile test if the patient has had three or more unformed stools within 24 hours Isolate patients with C. difficile immediately Wear gloves and gowns when treating patients with C. difficile, even during short visits. Hand sanitizer does not kill C. difficile, and although hand washing works better, it still may not be sufficient alone, thus the importance of gloves Clean room surfaces thoroughly on a daily basis while treating a patient with C. difficile and upon patient discharge or transfer. Supplement cleaning as needed with use of bleach or another EPA-approved, sporekilling disinfectant When a patient transfers, notify the new facility if the patient has a C. difficile infection 27
28 28 What s WRONG with this Picture?
29 What s WRONG with this Picture? Clostridium difficile is a spore-forming bacteria. These spores readily attach to clothes, hands, and equipment where they can survive for several months. People who have been on antibiotics are at greatest risk for developing a Clostridium difficile infection. Washing your hands with soap and water, cleaning equipment with bleach, and wearing isolation gowns and gloves will help to 29 stop the spread of the infection-causing spores. Additional information is available at What s wrong: The caregiver on the left is touching the doorpost of the isolation room while wearing an isolation gown and gloves. She is wearing a mask, which is not require for contact isolation. The caregiver on the right is reaching into the isolation room without wearing an isolation gown and gloves. What s right: Do not touch any surface or item outside the patient s room while wearing your isolation gown or gloves. Put on gloves before you hand an object to someone in a contact isolation room. Hands are the number one way that Clostridium difficile spores are spread.
30 30 What s WRONG with this Picture?
31 What s WRONG with this Picture? Clostridium difficile is a spore-forming bacteria. These spores readily attach to clothes, hands, and equipment where they can survive for several months. People who have been on antibiotics are at greatest risk for developing a Clostridium difficile infection. Washing your hands with soap and water, cleaning equipment with bleach, and wearing isolation gowns and gloves will help to 31 stop the spread of the infection-causing spores. Additional information is available at What s wrong: The transporter should not wear an isolation gown or gloves outside the patient s room. Masks are not required for contact isolation. What s right: Wash your hands and wear a gown and gloves before assisting patients while in their rooms. Patients should wash their hands before leaving their rooms. Discard your gown and gloves and wash your hands as you are leaving the room with the patient. Wash your hands and put on a fresh isolation gown and gloves prior to assisting patients at their destination.
32 32 What s WRONG with this Picture?
33 What s WRONG with this Picture? What s wrong: Used isolation gowns should not be hanging out of the container when they are removed. What s right: Contact isolation means that anyone entering the room must put on a fresh isolation gown and gloves. Before leaving, they must deposit those items into an appropriate container. Clostridium difficile is a spore-forming bacteria. These spores readily attach to clothes, hands, and equipment where they can survive for several months. People who have been on antibiotics are at greatest risk for developing a Clostridium difficile infection. Washing your hands with soap and water, cleaning equipment with bleach, and wearing isolation gowns and gloves will help to 33 stop the spread of the infection-causing spores. Additional information is available at
34 National Healthcare Safety Network (NHSN) LTC Resources 34
35 National Healthcare Safety Network ( NHSN) LTC Resources 35
36 Top 5 Reasons for NHs to Participate in NHSN and Antibiotic Stewardship Be a leader and become part of creating the first national CDI LTC baseline. Stay ahead of future federal requirements. On July 16, 2015, CMS published a proposed rule to require facilities to have a system for preventing, identifying, reporting, investigating, and controlling infections and communicable diseases. Larger hospitals are being penalized under the CMS value-based purchasing program for high infection rates. Partnering with nursing homes that have low infection rates will become an increasing priority for hospitals to thrive in their markets. The HHS National HAI Plan explicitly includes a priority focus on CDI. ( As Accountable Care Organizations proliferate, there will be limitations on their ability to partner with nursing homes that have less than a three-star rating. 36
37 New Opportunity New Opportunity - NHs can now participate in CDI NHSN data collection to establish a national baseline for LTC Learn about the principals of LTC Antibiotic Stewardship Learn effective communications through TeamSTEPPS JOIN US! 37
38 QUESTIONS??? Christine christine.larocca@area-d.hcqis.org Deanna deanna.curry@area-d.hcqis.org Linda linda.savage@area-d.hcqis.org Telligen QIN-QIO Website ( 38 This material was prepared by Telligen, Medicare Quality Innovation Network Quality Improvement Organization, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. 11SOW- CO-C2-1/
Guidelines for the Management of C. difficile Infections in. Healthcare Settings. Saskatchewan Infection Prevention and Control Program November 2015
Guidelines for the Management of C. difficile Infections in Healthcare Settings Saskatchewan Infection Prevention and Control Program November 2015 Agenda What is C. difficile infection (CDI)? How do we
More informationPreventing Hospital Acquired Infections: Clostridium difficile
Washington State Hospital Association Safe Table Preventing Hospital Acquired Infections: Clostridium difficile January 31, 2017 Lucia Austin-Gil, RN Jessica Symank, RN 2017 Infections Catheter Associated
More informationClostridium difficile
Clostridium difficile Michelle Luscombe & Karly Herberholz Hagel 5/14/2012 1 Outline What is clostridium difficile infection (CDI)? Symptoms & Complications Risk Factors Transmission Prevention and Control
More informationInvestigating Clostridium difficile Infections
CALIFORNIA DEPARTMENT OF PUBLIC HEALTH Investigating Clostridium difficile Infections Erin P. Garcia, MPH, CPH Healthcare-Associated Infections (HAI) Program Center for Health Care Quality California Department
More informationCDI Preventing and Managing Clostridium Difficile - A Provider's Perspective
Thank You for Joining! CDI Preventing and Managing Clostridium Difficile - A Provider's Perspective New England Nursing Home Quality Care Collaborative Webinar Will Begin Shortly. Call-In Number: (888)
More informationClostridium difficile Prevention Strategies A Review of Our Experience
Clostridium difficile Prevention Strategies A Review of Our Experience Suzanne R. Anders, MHI, RN Director, Hospital Patient Safety Health Services Advisory Group (HSAG) February 26, 2015 What is a Quality
More informationHRET HIIN MEASUREMENT MATTERS: Ground-breaking CDI Practices with Flowers Hospital in Alabama. June 5, :00 p.m. 1:00 p.m.
HRET HIIN MEASUREMENT MATTERS: Ground-breaking CDI Practices with Flowers Hospital in Alabama June 5, 2018 12:00 p.m. 1:00 p.m. CT 1 WELCOME AND INTRODUCTIONS Lydie Marc, MPH, CHES Program Manager, HRET
More informationClostridium difficile (C. diff)
Patient & Family Guide Clostridium difficile (C. diff) 2017 www.nshealth.ca Clostridium difficile (C. diff) What is C. diff? C. diff is a type of bacteria (germ) that is found in the intestine (gut or
More informationNursing Home Online Training Sessions Session 5: Clostridium difficile Part One: Clinical Overview
National Nursing Home Quality Care Collaborative Nursing Home Online Training Sessions Session 5: Clostridium difficile Part One: Clinical Overview Health Services Advisory Group (HSAG) Objectives 1 Welcome
More informationBeth Ann Ayala, Jim Lewis, and Tom Patterson DATE. Educating for Quality Improvement & Patient Safety
Beth Ann Ayala, Jim Lewis, and Tom Patterson DATE Educating for Quality Improvement & Patient Safety 1 The Team CSE participants Tom Patterson,MD - Professor of Medicine Division Head and Chief, Infectious
More informationProtocol for the Prevention and Management of Clostridium difficile.
Protocol for the Prevention and Management of Clostridium difficile. Policy Profile Policy Reference: Clinical care protocol 14. App D Clin 2.0 Version: Version 2.1 Author: Selma Mehdi, Lead Nurse Infection
More informationMontefiore s Clinical Microbiology Lab: Taking Aim at an Urgent Threat
Montefiore s Clinical Microbiology Lab: Taking Aim at an Urgent Threat Clostridium difficile bacteria. Protecting patients and the community at large from life-threatening microbial pathogens is a mission
More informationClostridium difficile GDH positive (Glutamate Dehydrogenase) toxin negative
Patient information Clostridium difficile GDH positive (Glutamate Dehydrogenase) toxin negative i Important information for all patients. Golden Jubilee National Hospital Agamemnon Street Clydebank, G81
More informationNursing Home Training Sessions Session 5: Clostridium difficile Part One: Clinical Overview
National Nursing Home Quality Care Collaborative (NNHQCC) II and the Clostridium difficile Infection (CDI) Initiative Nursing Home Training Sessions Session 5: Clostridium difficile Part One: Clinical
More informationInfection Control Update for Nursing Homes. Survey and Certification Group Centers for Medicare & Medicaid Services
Infection Control Update for Nursing Homes Survey and Certification Group Centers for Medicare & Medicaid Services Infection Prevention Update for Nursing Homes Daniel Schwartz, M.D., M.B.A. Chief Medical
More informationIs It Really a UTI? Do You Know It When You See It?
Is It Really a UTI? Do You Know It When You See It? Today s Objectives 1. Define Symptomatic UTI versus Asymptomatic Bacteriuria 2. Review RAI MDS Coding Manual Definition of UTI 3. Analyze UTI as a Quality
More informationRunning Head: REDUCING THE RISK OF CLOSTRIDIUM DIFFICILE HOSPITAL-WIDE 1. Reducing the Risk of Clostridium Difficile Hospital-Wide
Running Head: REDUCING THE RISK OF CLOSTRIDIUM DIFFICILE HOSPITAL-WIDE 1 Reducing the Risk of Clostridium Difficile Hospital-Wide Minot State University Senior Nursing Minot State University REDUCING THE
More informationBEHAVIORAL HEALTH & LTC. Mary Ann Kellar, RN, MA, CHES, IC March 2011
BEHAVIORAL HEALTH & LTC Mary Ann Kellar, RN, MA, CHES, IC March 2011 CDC Isolation Guidelines-adapting to special environments MDRO s CMS-F 441 C.difficile Norovirus Federal (CMS), State & Joint Commission
More informationClostridium difficile Infection (CDI)
Approved by: Clostridium difficile Infection (CDI) Vice President and Chief Medical Officer Corporate Policy & Procedures Manual VI-8 Date Approved August 22, 2016 September 16, 2016 Next Review (3 years
More informationInfection Control, Still the Most Commonly Cited Tag in Texas
July 2016 Commitment to Care Quality Topic Infection Control, Still the Most Commonly Cited Tag in Texas F -441 continues to show up on the list of top 10 deficiencies every quarter here in Texas. During
More informationCMS and NHSN: What s New for Infection Preventionists in 2013
CMS and NHSN: What s New for Infection Preventionists in 2013 Joan Hebden RN, MS, CIC Clinical Program Manager Sentri7 Wolters Kluwer Health - Clinical Solutions Objectives Define the current status of
More informationUse of Novel Approaches to Reduce Clostridium Difficile in an Inner City Hospital. Abstract
Use of Novel Approaches to Reduce Clostridium Difficile in an Inner City Hospital By Dr. Helene Paxton Reviewed by: Dr. Uyen Nguyen March 20, 2017 Abstract Background: Clostridium difficile is a spore-forming,
More informationClostridium difficile Infection (CDI) in children (3-16 years ) Transmission Based Precautions
Page 1 of 9 Standard Operating procedure (SOP) Objective To provide HCWs with details of the care required to prevent cross-infection in children s with Clostridium difficile Infection (CDI). This SOP
More informationLABORATORY IDENTIFIED (LABID) EVENT REPORTING MRSA BACTEREMIA AND C. DIFFICILE. National Healthcare Safety Network (NHSN)
LABORATORY IDENTIFIED (LABID) EVENT REPORTING MRSA BACTEREMIA AND C. DIFFICILE National Healthcare Safety Network (NHSN) CMS PARTICIPATION Acute care hospitals, Long Term Acute Care (LTACs),IP Rehabilitation
More informationIHA District Meetings February-March, : Iowa Environmental Assessment in Quality and Patient Safety HEN, QIN, TCPI, SIM
IHA District Meetings February-March, 2015 2015: Iowa Environmental Assessment in Quality and Patient Safety HEN, QIN, TCPI, SIM Looking Back 10 Years Ago IHA, AHA, CMS, IFMC, State of Iowa, JCAHO, AHRQ
More informationIncludes GP flow chart & out of hours protocols. Page 1 of 11
Clostridium Difficile Policy. Precautions to be observed when caring for ECCH in-patients colonised or infected with Clostridium Difficile (C.difficile) Includes GP flow chart & out of hours protocols
More informationFF C.DIFF C.DIFF C CLOSTRIDIUM DIFFICILE INFECTION
IFF IFF DIFF. DIFF C. DIFF FF C.DIFF C.DIFF C CLOSTRIDIUM DIFFICILE INFECTION Information for patients, their families and carers. What does it mean if someone has Clostridium difficile, or C. diff? These
More informationDecreasing Nosocomial C. diff
Decreasing Nosocomial C. diff Our journey to decreasing nosocomial C. diff Jennifer Conti BSN, RN, CIC Nicole Rabic MSN, RN, CIC 4.21.2016 Nosocomial C. diff Use of the CDC standardized definition Review
More informationHOSPITAL ACQUIRED COMPLICATIONS. Shruti Scott, DO, MPH Department of Medicine UCI Hospitalist Program
HOSPITAL ACQUIRED COMPLICATIONS Shruti Scott, DO, MPH Department of Medicine UCI Hospitalist Program HOSPITAL ACQUIRED COMPLICATIONS (HACS) A medical condition or complication that a patient develops during
More informationLearning Session 3: CDI Tracer and Assessment Tool
National Nursing Home Quality Care Collaborative (NNHQCC) II and the Clostridium difficile Infection (CDI) Initiative Learning Session 3: CDI Tracer and Assessment Tool Health Services Advisory Group (HSAG)
More informationClostridium difficile Algorithms for Long-term Care
Clostridium difficile lgorithms for Long-term Care 1 Early Recognition and esting 2 Contact Precautions 3 Room Placement 3.1 Identifying Lower Risk Roommates 4 Environmental Cleaning and Disinfection 5
More informationTelligen Update. Colorado s Medicare Quality Innovation Network- Quality Improvement Organization Christine LaRocca, MD.
Telligen Update Colorado s Medicare Quality Innovation Network- Quality Improvement Organization Christine LaRocca, MD April 27, 2018 Objectives (in 10 minutes or less) Who is Telligen? What do we do?
More informationActionable Patient Safety Solution (APSS) #2E: CLOSTRIDIUM DIFFICILE INFECTION (CDI)
Executive Summary Checklist Actionable Patient Safety Solution (APSS) #2E: CLOSTRIDIUM DIFFICILE INFECTION (CDI) In order to implement a program to eliminate Clostridium difficile infection (CDI) the following
More informationInfection Prevention, Control & Immunizations
Infection Control: This facility task must be used to investigate compliance at F880, F881, and F883. For the purpose of this task, staff includes employees, consultants, contractors, volunteers, and others
More informationInfection Control and Prevention On-site Review Tool Hospitals
Infection Control and Prevention On-site Review Tool Hospitals Section 1.C. Systems to Prevent Transmission of MDROs Ask these questions of the IP. 1.C.2 Systems are in place to designate patients known
More informationHealth Care Associated Infections in 2017 Acute Care Hospitals
Health Care Associated Infections in 2017 Acute Care Hospitals Christina Brandeburg, MPH Epidemiologist Katherine T. Fillo, Ph.D, RN-BC Director of Clinical Quality Improvement Eileen McHale, RN, BSN Healthcare
More informationAugust 22, Dear Sir or Madam:
August 22, 2012 Office of Disease Prevention and Health Promotion 1101 Wootton Parkway Suite LL100 Rockville, MD 20852 Attention: Draft Phase 3 Long-Term Care Facilities Module Dear Sir or Madam: The Society
More informationChecklists for Preventing and Controlling
Checklists for Preventing and Controlling Clostridium difficile Infection (CDI) This document has been developed to specifically assist senior management and all ward staff to take appropriate actions,
More informationNursing Home Online Training Sessions Session 4: Antibiotic Stewardship
National Nursing Home Quality Care Collaborative Nursing Home Online Training Sessions Session 4: Antibiotic Stewardship Health Services Advisory Group (HSAG) Objectives 1 Welcome and overview. 2 Define
More informationAHA/HRET HEN 2.0 PREVENTING AND DIAGNOSING C. DIFFICILE INFECTIONS: PRESERVE, PREDICT, PROTECT. December 14, :00 a.m. 12:30 p.m.
AHA/HRET HEN 2.0 PREVENTING AND DIAGNOSING C. DIFFICILE INFECTIONS: PRESERVE, PREDICT, PROTECT December 14, 2015 11:00 a.m. 12:30 p.m. CT 1 WELCOME AND INTRODUCTIONS Natalie Erb, Program Manager, HRET
More informationReducing CAUTI by Decreasing Inappropriate Catheter Utilization
Reducing CAUTI by Decreasing Inappropriate Catheter Utilization Reducing HAIs in Hospitals E. Eve Esslinger Jane Ehrhardt Heather Banker Debby Fosson Roddy Summers QIN-QIO Map HAIs Central Line-Associated
More informationClostridium difficile Infection (CDI) Trigger Tool
Hospital ward/clinical Area Date Trigger Tool Commenced Date Trigger Tool Closed Person closing the CDI Trigger Health Protection Scotland March 2014 Version 3.0 A CDI trigger is the number of new CDI
More informationHealth Care Associated Infections in 2015 Acute Care Hospitals
Health Care Associated Infections in 2015 Acute Care Hospitals Alfred DeMaria, M.D. State Epidemiologist Bureau of Infectious Disease and Laboratory Sciences Katherine T. Fillo, Ph.D, RN-BC Quality Improvement
More informationHOSPITAL QUALITY MEASURES. Overview of QM s
HOSPITAL QUALITY MEASURES Overview of QM s QUALITY MEASURES FOR HOSPITALS The overall rating defined by Hospital Compare summarizes up to 57 quality measures reflecting common conditions that hospitals
More informationHealthcare-Associated Infections in North Carolina
2017 Annual Report May 2017 Healthcare-Associated Infections in North Carolina 2016 Annual Report Product of: N.C. Surveillance of Healthcare-Associated and Resistant Pathogens Patient Safety (SHARPPS)
More informationPersonal Protective Equipment Use for Patients with Clostridium difficile
Murray State's Digital Commons Scholars Week Fall Scholars Week 2016 Nov 14th, 11:30 AM - 1:30 PM Personal Protective Equipment Use for Patients with Clostridium difficile Mallory L. Compton Murray State
More informationIMPROVEMENT IN PATIENT MANAGEMENT THROUGH THE USE OF A Clostridium difficile PCR REAL TIME STAND ALONE TEST IN ACUTE HOSPITAL SETTING
IMPROVEMENT IN PATIENT MANAGEMENT THROUGH THE USE OF A Clostridium difficile PCR REAL TIME STAND ALONE TEST IN ACUTE HOSPITAL SETTING Dr. Erminia Casari Director Microbiology Department Humanitas Hospital,
More informationClostridium difficile infection in Europe A CDI Europe Report
Clostridium difficile infection in Europe A CDI Europe Report April 2013 Astellas Pharma Europe Ltd. This report can be downloaded from www.epgonline.org/anti-infectivesknowledge-network/index.cfm and
More informationThe Culture of Culturing: The Importance of Knowing When to Order Urine Cultures. Today s Presenters
AHRQ Safety Program for Long-term Care: HAIs/CAUTI The Culture of Culturing: The Importance of Knowing When to Order Urine Cultures National Content Webinar Series October 15, 2015 Today s Presenters Barbara
More informationKristi Felix RN, BSN, CRRN, CIC, FAPIC Infection Prevention Coordinator Madonna Rehabilitation Hospitals
Kristi Felix RN, BSN, CRRN, CIC, FAPIC Infection Prevention Coordinator Madonna Rehabilitation Hospitals Resident safety-priority for staff and for CMS Providing care in a homelike environment but still
More informationPrevention and Control of Infection in Care Homes. Infection Prevention and Control Team Public Health Norfolk County Council January 2015
Prevention and Control of Infection in Care Homes Infection Prevention and Control Team Public Health Norfolk County Council January 2015 Content for today Importance of IPAC -refresher IPAC audits in
More informationCNA Training Advisor
CNA Training Advisor Volume 14 Issue No. 7 JULY 2016 Clostridium difficile, or C. diff, infection is a problem for immunocompromised people in every area of care. Over the years, C. diff infection has
More informationOHA HEN 2.0 Partnership for Patients Letter of Commitment
OHA HEN 2.0 Partnership for Patients Letter of Commitment To: Re: Request to Participate in the Ohio Hospital Association Hospital Engagement Contract Date: September 24, 2015 We have reviewed the information
More informationTelligen. Making BIG Changes Attainable with Affinity Group Outreach June 3, 2016
Telligen Making BIG Changes Attainable with Affinity Group Outreach June 3, 2016 1 Telligen QIN-QIO 2 For today Assess the landscape Evaluate how your projects align with affinity group interests Tell
More informationRunning head: DATA COLLECTION AND ANALYSIS IN SURVEILLANCE AND 1
Running head: DATA COLLECTION AND ANALYSIS IN SURVEILLANCE AND 1 Running head: DATA COLLECTION AND ANALYSIS IN SURVEILLANCE AND 2 Data Collection and Analysis of a Surveillance and Epidemiologic Investigation
More informationHealthcare associated infections across the health and social care community
Healthcare associated infections across the health and social care community Professor Brian Duerden CBE Inspector of Microbiology and Infection Control, Department of Health, London Infection is different..it
More informationC. difficile Infection and C. difficile Lab ID Reporting in NHSN
C. difficile Infection and C. difficile Lab ID Reporting in NHSN MARY ANDRUS, BA, RN, CIC Infection Preventionist Consultant Learning Objectives Review the structure and of the MDRO/CDAD Module within
More information5/9/17. Healthcare-Associated Infections Cultural Shift. Background. Disclosures and Disclaimers
National Center for Emerging and Zoonotic Infectious Diseases HAIs in Healthcare Settings: How Did We Get Here & What s Being Done to Address the Issue? Joseph Perz, DrPH MA Team Leader, Quality Standards
More informationClostridium difficile Infection (CDI) Intervention Kick-Off Webinar
Clostridium difficile Infection (CDI) Intervention Kick-Off Webinar Wednesday, January 17, 2018 National Nursing Home Quality Care Collaborative (NNHQCC) Health Services Advisory Group (HSAG) Introduction
More informationCommunity Data Update Knoxville Community Readmissions Coalition January 25 th, 2018
Community Data Update Knoxville Community Readmissions Coalition January 25 th, 2018 Corley Roberts, MHA, CPHQ, ACSM EP-C, EIM Quality Improvement Advisor, Qsource/atom Alliance croberts@qsource.org Readmissions
More informationRAISING THE BAR: IPRO s Medicare Quality Improvement Report for New York State ( )
RAISING THE BAR: IPRO s Medicare Quality Improvement Report for New York State (2011 2014) The Centers for Medicare & Medicaid Services (CMS) leads a national healthcare quality improvement program, which
More informationInpatient Quality Reporting Program
NHSN: Transition to the Rebaseline Guidance for Acute Care Facilities Questions and Answers Moderator: Candace Jackson, RN Project Lead, Hospital IQR Program Hospital Inpatient Value, Incentives, and Quality
More informationIncentives and Penalties
Incentives and Penalties CAUTI & Value Based Purchasing and Hospital Associated Conditions Penalties: How Your Hospital s CAUTI Rate Affects Payment Linda R. Greene, RN, MPS,CIC UR Highland Hospital Rochester,
More informationHSAG the QIN-QIO NHQCC II and CDI Initiative Kick-off
(HSAG) the Quality Innovation Network-Quality Improvement Organization Ohio National Nursing Home Quality Care Collaborative II (NHQCC II) Introduction James H. Barnhart III, BSH, LNHA Quality Improvement
More informationIntroduction to Infection Prevention and Control (IPC) Open Call Series #1 Surveillance
Introduction to Infection Prevention and Control (IPC) Open Call Series #1 Surveillance Diane Dohm MT, IP, CIC, CPHQ MetaStar February 6, 2018 IPC Open calls: Bi-weekly Series Surveillance What data should
More informationHAI Learning and Action Network February 11, 2015 Monthly Call. Overview of HAI LAN
HAI Learning and Action Network February 11, 2015 Monthly Call 1 Overview of HAI LAN CLABSI, CAUTI, CDI, VAE Conferred Rights through NHSN Monthly meetings/webex/teleconferences Antimicrobial Stewardship
More informationInfection Prevention and Control and Antibiotic Stewardship: More than Counting Beans
Infection Prevention and Control and Antibiotic Stewardship: More than Counting Beans Teresa Fox, CIC Quality Improvement Advisor teresa.fox@area-g.hcqis.org Welcome Beth Greene, Quality Improvement Advisor
More informationObjectives. IPC Open calls - bi-weekly series. Introduction to Infection Prevention & Control (IPC) Open Call Series
Introduction to Infection Prevention & Control (IPC) Open Call Series #4 Transmission Precautions Isolate the Organism and Not the Resident Diane Dohm MT, IP, CIC, CPHQ MetaStar Anne Haddad, MPH MPRO March
More informationInfection Control and Prevention On-site Review Tool Hospitals
Infection Control and Prevention On-site Review Tool Hospitals Section 1.C. Systems to Prevent Transmission of MDROs Ask these questions of the IP. 1.C.2 Systems are in place to designate patients known
More informationAttacking C.difficile Infections: Align the Team
D25 and E25 This presenter has nothing to disclose Attacking C.difficile Infections: Align the Team Georgine Kruedelbach MSN, RN, CIC Teresa Golden MSN, RN, NE-BC Donna Lee RN, BSN Demetrius Robinson,
More informationNHSN Update. Margaret A. Crowley, RN, PhD. 7 March 2016
NHSN Update Margaret A. Crowley, RN, PhD 7 March 2016 This material was prepared by the New England Quality Innovation Network-Quality Improvement Organization (QIN-QIO), the Medicare Quality Improvement
More informationStrategies to Prevent Clostridium difficile Infections in Acute Care Hospitals: 2014 Update
INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY JUNE 2014, VOL. 35, NO. S2 SHEA/lDSA PRACTICE RECOMMENDATION Strategies to Prevent Clostridium difficile Infections in Acute Care Hospitals: 2014 Update Erik
More informationProvincial Surveillance Protocol for Clostridium difficile infection
Provincial Surveillance Protocol for Clostridium difficile infection Table of Contents Background... 3 Clostridium difficile infection surveillance... 3 Purpose:... 3 Impact of Clostridium difficile infection:...
More informationHAI Learning and Action Network January 8, 2015 Monthly Call
HAI Learning and Action Network January 8, 2015 Monthly Call GPQIN Website greatplainsqin.org PATH: Website Initiatives Reducing HAI in Hospitals 2 HAI Page 3 4 5 Patient and Family Engagement Why should
More informationCDI Event Reporting for the National Healthcare and Safety Network (NHSN)
CDI Event Reporting for the National Healthcare and Safety Network (NHSN) Aimee Ford, MS, RN Jason Lempp, MPH,CIC Quality Improvement Consultants November 9, 2016 Qualis Health A leading national population
More informationOverview of Revised LTC Surveillance Definitions
Surveillance in Long-Term Care Facilities: Urinary Tract Infections (UTI) and Multidrug-Resistant Organisms (MDRO) Wisconsin Division of Public Health May-June 2014 Overview of Revised LTC Surveillance
More informationA New Vision for the Quality Improvement Organization Program
A New Vision for the Quality Improvement Organization Program This material was prepared by Masspro, the Medicare Quality Improvement Organization for Massachusetts, under contract with the Centers for
More informationLABORATORY-IDENTIFIED (LABID) EVENT REPORTING MRSA BACTEREMIA AND C. DIFFICILE. National Healthcare Safety Network (NHSN)
LABORATORY-IDENTIFIED (LABID) EVENT REPORTING MRSA BACTEREMIA AND C. DIFFICILE National Healthcare Safety Network (NHSN) CMS PARTICIPATION Acute care hospitals, Long Term Acute Care (LTACs),IP Rehabilitation
More informationNHSN Updates. Linda R Greene RN, MPS, CIC
NHSN Updates Linda R Greene RN, MPS, CIC linda.greene@urmc.rochester.edu Objectives Describe changes to NHSN definitions Explain how these changes are consistent with the HHS action plan Identify new prevention
More informationQuality Based Impacts to Medicare Inpatient Payments
Quality Based Impacts to Medicare Inpatient Payments Overview New Developments in Quality Based Reimbursement Recap of programs Hospital acquired conditions Readmission reduction program Value based purchasing
More informationC. difficile INFECTIONS
A REGIONAL APPROACH TO THE PREVENTION OF C. difficile INFECTIONS Ghinwa Dumyati, M.D. FSHEA Center for Community Health, University of Rochester Medical Center Elizabeth Dodds Ashley, PharmD MHS, FCCP,
More informationMedicare Quality Improvement Initiatives
Medicare Quality Improvement Initiatives Participation Opportunities in Minnesota February 2016 Achieve national quality goals in Minnesota. Join Stratis Health in working to achieve the Centers for Medicare
More informationWhen is it really a UTI?
When is it really a UTI? Adrienne Mims, MD, MPH, FAAFP, AGSF VP, Chief Medical Officer Adrienne.Mims@AlliantQuality.org 2/19/2016 1 Disclosure This educational activity does not have commercial support
More informationSelf-Instructional Packet (SIP)
Self-Instructional Packet (SIP) Advanced Infection Prevention and Control Training Module 4 Transmission Based Precautions February 11, 2013 Page 1 Learning Objectives Module One Introduction to Infection
More informationInfection Prevention and Control in Ambulatory Care Settings: Minimum Expectations for Safe Care
Infection Prevention and Control in Ambulatory Care Settings: Minimum Expectations for Safe Care Melissa Schaefer, MD Division of Healthcare Quality Promotion Centers for Disease Control and Prevention
More informationTaking Action to Prevent and Manage Multidrug-resistant Organisms and C. difficile in the Nursing Home: Part 3 Strategies to prevent
Taking Action to Prevent and Manage Multidrug-resistant Organisms and C. difficile in the Nursing Home: Part 3 Strategies to prevent Nimalie D. Stone, MD,MS Division of Healthcare Quality Promotion National
More informationHealthcare- Associated Infections in North Carolina
2018 Healthcare- Associated Infections in North Carolina Reference Document Revised June 2018 NC Surveillance for Healthcare-Associated and Resistant Pathogens Patient Safety Program NC Department of Health
More informationImplementing a C. difficile Testing Protocol Stephanie Swanson, MPH, CIC North Memorial Health
Implementing a C. difficile Testing Protocol Stephanie Swanson, MPH, CIC North Memorial Health Session objectives: Review NHSN CDI surveillance definition(s) Community vs. Hospital Onset Identify tactics
More information2014 Annual Continuing Education Module. Contents
This self-directed learning module contains information you are expected to know to protect yourself, our patients, and our guests. Content Experts: Infection Prevention Target Audience: All Teammates
More informationHospitals Face Challenges Implementing Evidence-Based Practices
United States Government Accountability Office Report to Congressional Requesters February 2016 PATIENT SAFETY Hospitals Face Challenges Implementing Evidence-Based Practices GAO-16-308 February 2016 PATIENT
More informationJune 24, Dear Ms. Tavenner:
1275 K Street, NW, Suite 1000 Washington, DC 20005-4006 Phone: 202/789-1890 Fax: 202/789-1899 apicinfo@apic.org www.apic.org June 24, 2013 Ms. Marilyn Tavenner Administrator Centers for Medicare & Medicaid
More informationClostridium difficile Infection (CDI) Trigger Tool
Hospital ward/clinical Area Date Trigger Tool Commenced Date Trigger Tool Closed Person closing the CDI Trigger Health Protection Scotland V2.0 November 2011 A CDI Trigger is the point at which the Infection
More informationClinical Guidance on the Identification and Evaluation of Possible SARS-CoV Disease among Persons Presenting with Community-Acquired Illness Version 2
GUIDANCE AND RECOMMENDATIONS Clinical Guidance on the Identification and Evaluation of Possible SARS-CoV Disease among Persons Presenting with Community-Acquired Illness Version 2 This document provides
More informationIdentify patients with Active Surveillance Cultures (ASC)
MRSA CHANGE STRATEGIES The following tables include change strategies proven to be effective in healthcare settings. Implementing these changes through current or new processes may result in reducing healthcare
More informationEvidence Based Practices to Prevent HAIs/CAUTI and Improve Resident Safety
AHRQ Safety Program for Long term Care: HAIs/CAUTI Evidence Based Practices to Prevent HAIs/CAUTI and Improve Resident Safety Objectives Upon completion of this module, participants will be able to: Describe
More informationActionable Patient Safety Solution (APSS) #2E: CLOSTRIDIUM DIFFICILE INFECTION
Actionable Patient Safety Solution (APSS) #2E: CLOSTRIDIUM DIFFICILE INFECTION Endorsed by: The trademarks listed above are used with permission of the respective owners. Executive Summary Checklist Clostridium
More informationUnderstanding Hospital Value-Based Purchasing
VBP Understanding Hospital Value-Based Purchasing Updated 12/2017 Starting in October 2012, Medicare began rewarding hospitals that provide high-quality care for their patients through the new Hospital
More informationInfection Prevention Implementation and adherence to infection prevention practices are the keys to preventing the transmission of infectious diseases
Infection Prevention Infection Prevention Implementation and adherence to infection prevention practices are the keys to preventing the transmission of infectious diseases to yourself, family members,
More informationPOLICY FOR THE PREVENTION AND CONTROL OF CLOSTRIDIUM DIFFICILE INFECTION (CDI)
POLICY FOR THE PREVENTION AND CONTROL OF CLOSTRIDIUM DIFFICILE INFECTION (CDI) Please be aware that this printed version of the Policy may NOT be the latest version. Staff are reminded that they should
More informationBUGS BE GONE: Reducing HAIs and Streamlining Care!
BUGS BE GONE: Reducing HAIs and Streamlining Care! SUSAN WHITNEY, RN, PCCN, MM, BME FLORIDA HOSPITAL ORLANDO, FL SUWHIT@AOL.COM LEARNING OUTCOMES 1. Describe HAI s and the impact disposable ECG leads have
More information