Date of Award
Doctor of Nursing Practice (DNP)
Practice Problem: At a small community facility in Los Angeles County, there was a reporting rate of hospital-acquired Clostridium difficile cases that was higher than both state and national benchmarks.
PICOT: The PICOT question that guided this project was: In acute care patients aged 18-90, does not retesting for CDI for at least seven days compared to retesting in less than seven days reduce the incidence of false positive CDI tests during the first seven days of the hospital stay?
Evidence: The evidence demonstrates that if patients are tested initially for Clostridium difficile and then retested seven days after, the rate of hospital-acquired Clostridium difficile decreases.
Intervention: A facility policy was implemented to restrict CDI testing until seven or more days after the initial test.
Outcome: A total of 19 patients were initially tested for Clostridium difficile. Medical personnel determined that only two of those patients needed a second test, which was done after seven days. There were no hospital-acquired cases during the project period, unlike during the same time frame the previous year.
Conclusion: The project results supported the literature showing that waiting seven days before performing a repeat Clostridium difficile test can reduce the number of hospital-acquired Clostridium difficile cases by reducing false positives. This was beneficial to the hospital which was able to reduce costs, and improve the quality of the care.
Hidalgo, N. (2020). A Policy Change to Reduce Hospital-Acquired Clostridium Difficile Infection Rates: A Quality Improvement Project. [Doctoral project, University of St Augustine for Health Sciences]. SOAR @ USA: Student Scholarly Projects Collection. https://doi.org/10.46409/sr.CZCD1350
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