Patients with kidney disease have an elevated C. diff risk, leading to elevated infection rates at hospital nephrology units.Misclassified cases and poor protocol compliance prompted a multidisciplinary strategy with targeted education, cleanings, and peer coaching.The nurse-driven intervention cut hospital-acquired C. diff rates by 90%.
An inpatient nephrology unit reduced hospital-acquired Clostridioides difficile (C. diff) infections by 90% after implementing nurse-driven protocols.
Between January and April 2023, Detroit's Henry Ford Hospital nephrology unit recorded a hospital-onset C. diff infection (HO-CDI) rate of 34 per 10,000 patient-days -- far above the hospital average of 3.8, Rachel Smith, RN, and colleagues reported in an NEJM Catalyst Innovations in Care Delivery case study.
After targeted interventions in May and June 2023, the unit's HO-CDI rate fell to 9 per 10,000 patient-days by November, representing a 73% drop in cases. From December 2023 through December 2024, the unit maintained this reduced rate, averaging 3.34 cases per 10,000 patient-days, reflecting a 90% reduction.
C. diff causes severe gastrointestinal symptoms, leading to nearly 500,000 U.S. infections and 29,000 deaths annually. "Patients with chronic kidney disease and end-stage renal disease are at particularly high risk as a result of frequent antibiotic exposure, altered immunity, and gastric acid suppression," Smith's group explained.
