Clostridium difficile: How Much do Hospital Staff Know About it?

Abstract

Ann RC oll Surg Engl 2009; 91:4 64-469 464Clostridium difficile is an opportunistic, Gram-positive, anaerobic, spore-formingb acillus. Its clinical effects can range from mild self-limiting diarrhoea to life-threatening toxic megacolon and peritonitis. After methicillin-resistant Staphylococcus aureus infection (MRSA), C. difficile is the most wide-spread hospital acquired infection in the UK. In the UK, MRSA infection rates are declining, but rates of C. difficile infection continue to rise. There are several reasons for the increasing incidence of C. difficile infection. One possible reason could be lack of awareness and adequate knowledge among healthcare professionals. There are no studies in the literature that examined the level of healthcare professional's knowledge about C. difficile infection. We,t herefore,c onducted aq uestionnaire-based survey within our hospital to address this issue. Subjects and MethodsAq uestionnaire-based survey was conducted in Weston General Hospital, UK, in January 2007. Eligible participants included doctors, nurses, dieticians, physiotherapists, and theatre staff. Participants were recruited on av oluntary SUBJECTS AND METHODS At otal of 132 healthcare professionals (18 consultants, 40 trainee doctors, and 74 nursing staff) in our hospital were randomly surveyed using aq uestionnaire consisting of 17 questions covering various aspects of C. difficile. GENERAL SURGERYRESULTS More than 50% of healthcare professionals correctly identified C. difficile as an anaerobic bacillus. Half of the consultants and one-third of the trainees and nurses were aware that 5% of adults carry C. difficile in the gut. Overall, 80% of doctors and 40% of nursing staff (P =0 .001) were aware of the spectrum of illnesses causedb yC. difficile.S even (39%) consultants, 25 (63%) trainees, and 26 (37%) nurses correctly identified the various predisposing factors for the acquisition of C. difficile infection. Only one-third of doctors and 8% of nursing staff were aware that antibiotic restriction was the single most effective C. difficile infection control measure. In addition, 40% of doctors and 8% of nursing staff were aware that cytotoxin assay is the gold standard diagnostic test. Less than 30% of healthcare professionals were aware of the differences between the most common strain and the strain of C. difficile responsible for recent outbreaks. Only 6( 33%) consultants, 21 (53%) trainees (P =n ot significant), and 28 (38%) nursing staff were aware that hand washing with soap and water is the most effective way of preventing transmission of C. difficile infection. Results showed that 93% of trainees, 78% of consultants (P =0 .05) and 70% of nurses correctly answered that oral metronidazolei st he drug of choice for the treatment of C. difficile infection. Compared to 73% of trainees, only two (11%) consultants (P <0 .0001) and 20 (27%) nursing staff correctly stated that oral vancomycin is the second-line treatment for persistent symptomatic C. difficile infection.CONCLUSIONS There is as ignificant...

Lack of adherence to SHEA-IDSA treatment guidelines for Clostridium difficile infection is associated with increased mortality

“…11,12 Studies have documented deficiencies in the knowledge and awareness of CDI guidelines amongst medical professionals as well as a lack of conformation to recommended treatment approaches. 13,14 Thus, we elected to perform a quality improvement study at our hospital with two main goals: (i) to determine the degree of adherence to clinical practice guidelines among healthcare providers; and (ii) to determine whether deviation from the guidelines may have an impact on patient outcomes.…”

Microbiology Education in Nursing Practice

“…We find it concerning that approximately one in four surveyed nurses did not have a microbiology course as part of their nursing education, given that these topics are unlikely to be covered with a microbiology focus in other nursing curriculum courses. The literature has established that nurses need to understand microbiology topics in order to effectively prevent and recognize healthcare-acquired infections ( 6 , 12 – 15 , 21 , 22 ). Foundational knowledge of disease transmission and prevention is critical.…”

Knowledge of Clostridium difficile infection among UK health-care workers: development of a knowledge assessment tool

“…Previously published questionnaires by Aroori et al 14 and Tsagkaraki et al 15 were used to produce our assessment tools. All content was initially included; however, evaluation of the combined questionnaire identified statements that were duplicated or highly similar in both original questionnaires.…”

“…12 A robust CDI knowledge assessment tool could have many uses, including better identification and assessment of an individual's need for education, monitoring of the effectiveness of interventions and identifying trends and, finally, allowing comparisons of knowledge levels in different HCW populations, both locally and nationally. 13 Recent reports confirm a lack of knowledge of CDI among HCWs, 14,15 but such studies may be undermined by the limited translational relevance they possess; the assessment tool employed within each study had been utilized in discrete HCW populations without repetition or having undergone a validation/development process. Furthermore, neither specify an appropriate level of knowledge or 'pass' grade.…”

“…Recent reports confirm a lack of knowledge of CDI among HCWs, 14,15 but such studies may be undermined by the limited translational relevance they possess; the assessment tool employed within each study had been utilized in discrete HCW populations without repetition or having undergone a validation/development process. Furthermore, neither specify an appropriate level of knowledge or ‘pass’ grade.…”