Elimination Of Healthcare Associated Infections

Clostridium difficile Programs

C.difficile Prevention Partnership Collaborative

Regional Team Workshops January, 2012
Workshops Announcement and Agenda

• Learn how hospital / SNF clusters in your area are working together
• Learn techniques to engage front line staff as active participants in infection prevention
• Work with colleagues to:
  1. develop an approach to communication around transfers between facilities;
  2. discuss best practices in environmental cleaning and disinfection as well as strategies for implementation; and
  3. identify contact precautions and isolation strategies that can work for your facility and residents / patients.

Workshops Held (January 24th , 25th , 26th , 31st , 2012) at:

• Lowell General Hospital
• Baystate Medical Center
• Jordan Hospital
• UMASS Memorial Medical Center

Presentations — Click here to download Adobe Acrobat file of all presentations listed below.

• Table Talk: What have you noticed? What have you changed?
• Engaging Everyone in Finding Solutions
  • Engaging frontline staff in identifying and making improvements to prevent transmission of C.difficile infection
    • Implementing precautions
    • Environmental cleaning and disinfection
    • Communication about infections at time of inter-facility transfer
• Small Tests of Change
  • Using quality improvement to test and implement changes to prevent C.difficile infection

Handouts

• Toolkit Table of Contents (Click here to see November 15, 2011 program Handout section to access documents on this list)
• Practice Opportunities for C.difficile Prevention
• Inter-Facility Infection Control Transfer Form
• PDSA Worksheet
• Discovery and Action Cheat Sheet

Hospital Collaborative & Team Workshops

C.difficile Prevention Workshop November 15, 2011
Program Announcement and Agenda

Presentations

• Nov. 15 2011 Introduction
• Looking at Our Results - Focus on Change
• What Works - Successful Strategies from Collaborative Participants - Part I
• What Works - Successful Strategies from Collaborative Participants - Part II
• Partnership Collaborative Launch
• Clostridium difficile Management in Healthcare Facilities

Faculty/Program Committee

• Paula Griswold, MS, MA Coalition for the Prevention of Medical Errors
• Susanne Salem Schatz, ScD, MA Coalition for the Prevention of Medical Errors
• Sharon Benjamin, PhD, Alchemy
• Gail Bennett, MSN, RN, CIC, ICP Associates, Inc.
• Laurie Herndon, MSN, GNP-BC, ANP-BC
• Helen Magliozzi, RN, MA Senior Care Foundation
• Alfred DeMaria, MD, Medical Director, Bureau of Infectious Disease, Prevention, Response and Services; State Epidemiologist, Massachusetts Department of Public Health

Handouts

• Mass CDI Collaborative Hospital - How Did We Do through Sept 2011 – Blinded Run Charts
• MA CDI Rates per 10,000 patient days
• What We Know About Creating Change
• Practice Opportunities Worksheet for Hospitals and SNFs
• PDSA Worksheet
• Learning Visit Notes

Toolkit Table of Contents

CDI Prevention Guidelines and Policies

• APIC / SHEA Guideline: Infection prevention and control in the long term care facility Clinical Practice Guidelines for Clostridium difficile
• Infection in Adults: 2010 Update by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA)
• Clostridium difficile and Clostridium-difficile associated disease Infection Control Guidelines for Long-Term Care Facilities Massachusetts Department of Public Health Division of Epidemiology and Immunization
• APIC Guide to the Elimination of C. Difficile in Health Care Settings
• Northeast Hospitals Corporation CDI Bundle Program
• Harrington Hospital Clostridium Difficile Policy
• Harrington C difficile Treatment Guidelines

APIC New England Presentations by CDI Prevention Collaborative Teams

• Cooley Dickinson Hospital – APIC Presentation – Environmental Services-Microsystems Team – October 2011
• Noble Hospital – APIC Presentation – Cdiff Reduction Utilizing an Interdepartmental Team Approach
• St. Vincent Hospital – "No Butts About It, Let"s Wipe it Away"

Patient Assessment and Testing

• National Health Service (Bristol) Stool Chart
• Baron BM Chart for C. difficile Assay (Harrington Hospital)
• C. difficile Testing Guidance (Massachusetts DPH)

Patient Placement

• Centers for Disease Control 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings: Web address
• Southcoast Hospitals C. difficile Isolation Algorithm

Patient and Family Education

• Centers for Disease Control CDI FAQs
• Centers for Disease Control CDI FAQs Spanish
• New England Baptist Hospital C. Difficile Patient Information Sheet
• New England Baptist Hospital Contact Precautions Visitor Instructions
• New England Baptist Hospital Patient and Family Hand Hygiene Brochure

Hand Hygiene

• Centers for Disease Control Hand Hygiene Guidelines in Healthcare Settings
• CDC Hand Hygiene Screen Shot
• World Health Organization 5 Moments for Hand Hygiene Poster
• Ontario "Just Clean Your Hands" Program
• JCAHO "Targeted Tools" for Hand Hygiene (web resources)
• Cooley Dickinson Hospital Hand Washing Bathroom Reminder Sign
• New England Baptist Hospital C. difficile Hand Hygiene poster
• Saint Vincent Hospital Hand Hygiene Monitoring Guideline
• Saint Vincent Hospital Hand Hygiene Monitoring Tool
• Saint Vincent Hospital Got Hands? Little Boy Hand Hygiene Poster
• Saint Vincent Hospital Got Paws Kitten Hand Hygiene Poster
• Baystate Franklin "Have you been spotted?" Poster
• Baystate Franklin Hand Hygiene Raffle Ticket

Contact Precautions

• Centers for Disease Control Graphics for Donning and Removing PPE
• Cooley Dickinson Hospital Precautions Sign  with List of Conditions that Require Precautions
• Cape Cod Hospital Enteric Precautions Sign
• Marlborough Hospital Transport Form "Ticket to Ride"
• Harrington Hospital Contact Precautions Plus Sign
• Noble Hospital Contact Precautions for C. Difficile Sign

Cleaning and Disinfection of Equipment and Environment

• Centers for Disease Environmental Infection Control in Health Care Facilities
• Centers for Disease Control Cleaning Checklist (adapted)
• CDI Cleaning Bundle Strategies (Pennsylvania Improvement Collaborative)
• Cooley Dickinson Hospital 9 Step Cleaning Process
• Cape Cod Hospital Combination Cleaning and Disinfectant Products Guide
• Franciscan Hospital for Children Cleaning of Reusable Patient Care Equipment Policy
• Research, EBP, Quality Improvement : Fairview Hospital Slide Presentation on the Switch to Micro Fiber Mops

Antibiotic Stewardship

• Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America Guidelines for Developing an Institutional Program to Enhance Antimicrobial Stewardship Clinical Infectious Diseases 2007; 44:159–77
• MetroWest Medical Center “Dear Doctor” Letter
• MetroWest Medical Center P&T Fluoroquinolone Alternative Recommendations

Patient Transfer Communication

• Centers for Disease Control Interfacility Transfer Communication Form
• Tewksbury Hospital Communication with Referring Facilities

Measurement

• Partnership Collaborative CDI Measure Definitions
• Clostridium difficile Line Listing Sheet
• New England Sinai Hospital and Rehabilitation Center Hand Hygiene and PPE Observation Form

Process Improvement Tools

• C. difficile Cause Analysis Tool (from CDI Prevention Collaborative 2010-2011)
• Baystate Medical Center “Fishbone” Cause Analysis Tool
• PDSA Planning Tool

Hospital C.difficile Prevention Collaborative

C. diff Prevention Collaborative Hospital Team Workshop
March 29, 2011 Program Announcement and Agenda

Presentations

• Ten Months In: What Have We Accomplished and What's Next
  Paula Griswold, Susanne Salem Schatz - MA Coalition
• C.diff Reduction Utilizing an Interdepartmental Team Approach
  Mary Jane Lamb, Susan St. - Jean Noble Hospital
• No Butts About It, Lets Wipe It Away
  Debra Berube, St. Vincents Hospital
• C.diff Improvement Work
  Sue Valentine - Harrington Hospital
• Environmental Services Leaders in Infection Prevention
  Daniel English, Linda Riley - Cooley Dickinson Hospital
• C.difficile Screening and Identification Myths: fact or fiction
  Lisa Davidson - Tufts University School of Medicine
• Antimicrobial Stewardship: An Important Piece of the Puzzle to Improving Patient Outcomes and Reducing Healthcare Associated Infections (Large file 5.3M, this may download as a .zip file)*
  Kenneth Lawrence - Tufts Medical Center
• Antibiotic Stewardship at MetroWest Medical Center
  Colleen Grocer - MetroWest Medical Center
• Quinolone Restriction
  Vibha Sharma Tim Yang - Marlborough Hospital
• A Team Approach to Antibiotic Stewarship
  Jeffrey Powis Yves Crehore Sue Gill - Toronto East General Hospital

C. diff Prevention Collaborative Team Workshop
June 24, 2010 Program Announcement and Agenda

Presentations

• Introduction and Next Step Slides
  Paula Griswold, Susanne Salem-Schatz - MA Coalition
• Preventing Transmission of C. diff: Principles of Prevention
  Carolyn Gould - Centers for Disease Control
• Optimizing Environmental Hygiene: The Key To C. diff Control
  Phil Carling, MD - Carney Hospital
• Preventing Transmission Of C.difficile: Practice
  Elise Tamplin - Brigham & Womens Hospital
• Using Measurement To Inform And Improve
  Maureen Spencer - N.E. Baptist Hospital
• Building on Patient Safety: C. diff Practice Opportunities
  Mary Ellen Scales - Bay State Medical Center
• Learning Our Way To Improvement: Pulling It Together
  Susanne Salem-Schatz - MA Coalition
• How Huddles Improved Hand Hygiene and Reduced VRE
  Colleen Zidik, Rebecca Spitz, Jeanne Barton, Susan ORourke, Miriam Perez- Brigham & Women’s Hospital
• Front-line Staff: a Force for Excellence in Reducing Hospital Acquired Infections
  Karen Peters, Pamela Linzer, Stephanie Foster, Alison Barbush, Katie Marshall - Winchester Hospital
• Turning Corners Across the Border in Eliminating C-Diff
  Tracey Fletcher - University Health Network, Toronto Western Hospital
  Liz Rykert - Ontario Agency for Health Protection and Control
• Practice Using Conversation for Improvement
  Sharon Benjamin - Alchemy & Plexus Institute

Tools

• Baystate Medical Center C.diff Algorithm
• Huddle Checklist Improving Hand Hygiene Reduce VRE
• PDSA Planning Worksheet
• Practice Assessment Planning Chart
• Sample Practice Planning Worksheet
• Practice Planning Worksheet
• Action Steps When Diarrhoea Diagnosed C.diff Stool Chart
• C.diff Measure Collaborative Definition
• Practice Opportunities for C.diff Prevention

Resources

• Clinical Practice Guidelines for C.diff in Adults ICHE May 2010
• Does My Patient Have C.diff? Annals 2009
• Guidelines for Developing Program to Enhance Antibiotic Stewardship

Audio Conferences

C. difficile Prevention Partnership Collaborative Coaching Call: C. difficile Management in Healthcare Facilities
January 19, 2012

Featuring: Phenelle Segal, RN CIC, President, Infection Control Consulting Services

Presentation

C. difficile Prevention Partnership Collaborative Coaching Call
December 8, 2011

Presentation

• December 8 Coaching Call slides

C. diff Prevention Collaborative
November 9, 2011

Team Discussion No Slides

C. difficile Prevention Collaborative Monthly Team Coaching Call
September 21, 2011

Featuring:
Jane Taylor, Ed.D

Presentation

C. difficile Prevention Collaborative Monthly Coaching Call
July 19, 2011

Tools

• Baystate CDI Fishbone
• CDI Cause Analysis
• Milford CDIFF Cause Analysis Spreadsheet

CDI Prevention Collaborative Call for Teams
October 13, 2010

Presentation

• Using Root Cause Analysis to Tackle C.difficile Infections
  Tony Maggs - Torbay Hospital, National Health Service

Tools and Resources

• New Adverse Event Risk Assessment Form (MRSA Screen)
• Session 4 Root Cause Analysis
  • C.diff Standard Practices
  • Outcome Report
  • C.diff Briefing
  • C.diff Trigger Questions

C. diff Prevention Collaborative Kick-off call for Teams
June 2, 2010 Program Announcement

Presentation

Leadership

C. difficile Prevention Partnership Collaborative Leadership Call
January 4, 2012

Featuring

• Doreen Hutchinson, RN, Vice President of Operations and Chief Nursing Office, Fairview Hospital
• Ellen Candlish, Director of Nursing, Laurel Lake Center for Health and Rehabilitation

Presentation

• January 4 2012 leadership call

C. diff Prevention Collaborative Kick-off call for Hospital Senior Leaders
May 4, 2010 Program Announcement

Presentations

• Infection Prevention Strategies for Success
  Mairead Hickey Brigham & Womens Hospital
• Role of the Executive Sponsor: Reflections from Winchester Hospital
  Richard Iseke Winchester Hospital

*This file may download as a .zip file. Please contact ebrickman@macoalition.org with any questions.

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