Provider staffing levels are hindering efforts to prevent C.difficile infections

C. difficile bacteria

C. difficile bacteria

A new survey shows that despite providers stepping up efforts to prevent deadly C.difficile infections, those efforts are not producing significant results, according to a new survey by the Association for Professionals in Infection Control and Epidemiology. One reason behind that is hospitals don’t have sufficient staff levels of infection control experts or infection preventionists to combat the problem, according to the president-elect of the association.

Although C.difficile rates have reached historic highs, according to the survey, only one in five of the 1,087 survey respondents have been able to add more infection prevention staff in the past three years. About 78 percent of the respondents work in acute care settings, 9 percent work in long term care and 4 percent in ambulatory care.  The rest of the respondents work in long-term acute care, rehabilitation, behavioral health, and hospice settings.

C.difficile causes diarrhea, fever, nausea and abdominal pain and is estimated to kill 14,000 people each year, according to the Centers for Disease Control and Prevention. Deaths associated with the bacteria rose 400 percent between 2000 and 2007 because of a stronger germ strain. C.difficile has been estimated to add at least $1 billion annually to U.S. healthcare costs, according to APIC.


“We are concerned that staffing levels are not adequate to address the scope of the problem,” Jennie Mayfield, APIC president-elect and clinical epidemiologist at Barnes-Jewish Hospital, said in a statement.

One possible reason why C.difficile has remained a pervasive problem is the way it is monitored. Although 92 percent have increased their focus on environmental cleaning and equipment decontamination practices in the past three years, about 64 percent of respondents said they rely on observation, as opposed to more accurate and reliable monitoring technologies to assess cleaning effectiveness.

A lack of a national practice recommendation as to the precautions providers should take with patients with the condition was also cited as a potential problem. More than 40 percent of respondents keep C.difficile patients in isolation from admission to discharge, but 25 percent of respondents keep these patients in isolation until treatment has started and they have not had diarrhea for 48 hours.

C. difficile spores can survive in the environment for many months, environmental cleaning and disinfection are critical to prevent the transmission of CDI,” said Mayfield. “Environmental Services must take the lead in developing aggressive programs to monitor cleaning practices and then ensure that the results are shared with front-line staff. Without that buy-in, practices are unlikely to improve.”

A need to make patients aware of the issue was highlighted in the survey with only 50 percent of respondents initiating these programs.

Innovations to help providers do a better job of detecting and treating hospital acquired infections have also been in the works. FCubed LLC developed a device to detect the presence of MRSA. Xenex Healthcare Services has a portable disinfection system in which an ultraviolet flash lamp emits pulses of the inert gas xenon at a rapid speed and high intensity, producing UVC radiation. At certain wavelengths, the UV light can penetrate the cell walls of bacteria, viruses, mold and spores and prevent them from replicating. Pennsylvania-based Life Aire Systems has also developed an air purification system aimed at eliminating hospital acquired infections.

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