Clostridium difficile Infection (CDI): Use of Preventive Bundle to Decrease CDI Incidences

Clostridium difficile Infection (CDI): Use of Preventive Bundle to Decrease CDI Incidences by Lisa Feliciano MSN, Walden University, 2009 BSN, Northwestern State University, 2005 ADN, Northwestern State University, 2000 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University July 2018 Abstract The challenge of combating Clostridium difficile infections (CDI) is a major problem within many health care organizations as CDI adds to the cost of care and is an uncomfortable and sometimes fatal complication of hospitalization for the patient. The practice-focused question for this doctoral project was targeted at patients in hospital settings on a medical surgical floor and asked if clostridium difficile preventive bundles reduce the incidence of CDI compared with nonstandardized preventative methods. Using the plan-do-study-act framework, the purpose of this DNP project was to use a clostridium difficile bundle approach to study the effects of clostridium difficile incidence (CDI) decrease on a medical-surgical unit with high CDI incidences. Standardized environmental cleaning practices resulted in improvement of the patient environment. High-touch cleaning improved from 43.7% to 83.3%. Time between CDI events lengthened from 19.9 days to 30.2, environmental cleaning with the use of Dazo auditing improved from 33.4% to 81.6%, isolation practices improved from 62.7% to 90%, and with the implementation of the nurse-driven CD testing protocol, unnecessary testing improved. Results showed that the CDI incidence on an acute care medical surgical unit was reduced through the use of a clostridium difficile preventive bundle in this DNP project. Reducing the incidence of CDI is a significant contribution to social change as this unwanted complication of hospitalization causes discomfort and pain and adds unnecessary cost to health care.The challenge of combating Clostridium difficile infections (CDI) is a major problem within many health care organizations as CDI adds to the cost of care and is an uncomfortable and sometimes fatal complication of hospitalization for the patient. The practice-focused question for this doctoral project was targeted at patients in hospital settings on a medical surgical floor and asked if clostridium difficile preventive bundles reduce the incidence of CDI compared with nonstandardized preventative methods. Using the plan-do-study-act framework, the purpose of this DNP project was to use a clostridium difficile bundle approach to study the effects of clostridium difficile incidence (CDI) decrease on a medical-surgical unit with high CDI incidences. Standardized environmental cleaning practices resulted in improvement of the patient environment. High-touch cleaning improved from 43.7% to 83.3%. Time between CDI events lengthened from 19.9 days to 30.2, environmental cleaning with the use of Dazo auditing improved from 33.4% to 81.6%, isolation practices improved from 62.7% to 90%, and with the implementation of the nurse-driven CD testing protocol, unnecessary testing improved. Results showed that the CDI incidence on an acute care medical surgical unit was reduced through the use of a clostridium difficile preventive bundle in this DNP project. Reducing the incidence of CDI is a significant contribution to social change as this unwanted complication of hospitalization causes discomfort and pain and adds unnecessary cost to health care. Clostridium difficile Infection (CDI): Use of Preventive Bundle to Decrease CDI Incidences by Lisa Feliciano MSN, Walden University, 2009 BSN, Northwestern State University, 2005 ADN, Northwestern State University, 2000 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University July 2018 Dedication This doctoral project is dedicated to the many patients whom suffer from clostridium difficile infections and to all future nursing students to ensure that you can achieve your dreams; you just have to be persistent and set life-long career goals. Acknowledgments I would like to thank my Lord and Savior Jesus Christ, as without him, I could not have continued the needed faith to follow my career dreams, successes, and dream to be a change agent in nursing. To my husband, Hendrix, you have allowed me to pursue my continued education to achieve the upmost degree in nursing, and for this I thank you. To my children, Yasmine and Jakob, thank you for your selfless sacrifice to allow me to continue my dreams. Hard work and sacrifice pays off! To my family, friends and colleagues, thank you for all your continued support. To my professional mentors throughout my career, Mrs. Laura Smith (I know you are smiling in Heaven), Dr. Barbara Niedz, Dr. Amy Donaldson, and Mrs. Catherine Blise, thank you for your continued support throughout my education journey. Lastly, I would like to thank my project site for allowing me to further my education.