North Texas Research Forum 2024



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North Texas


Medical City Arlington


Family Medicine

Document Type


Publication Date



Clostridium difficile, Clostridium difficile infection, hospital acquired infections, quality improvement


Bacterial Infections and Mycoses | Family Medicine | Medicine and Health Sciences | Quality Improvement


INTRODUCTION: Hospital acquired Clostridium difficile infection are one of the costliest hospital acquired infections. Over the past year, there were 19 C diff cases. Reasons for this uptick in cases from previous years could be waiting too long for collection (where a patient has C diff on admission, but does not receive testing until several days later), antibiotics, environmental (for example, using the same toilet brush to clean bathrooms on the floor as well as the bathroom in a C diff patient's room, cleaning high touch areas less than two times during the day, etc.), or staff education. From our meeting with the Infection Prevention team, there is a possibility that the recent cases in question were not hospital acquired, but resulted from failure to test a sample within the first three days or admission. Therefore, we sought to test this theory by researching staff understanding of the C diff MCA protocol. METHODS: A survey was created and distributed to various nursing staff, fellow residents, and physicians regarding the C diff protocol at MCA. The survey was distributed during scholarly activity presentations in resident didactics, lunch and learns, and during various other presentations throughout the hospital. Questions included when testing was appropriate, what can prevent C diff infections, if the participant had seen any C diff cases within the last year, and what was their understanding of the C diff protocol was. Questions were a mix of free response and yes or no. Approximately 196 responses were obtained from the survey. RESULTS: Although there was significant variability in the understanding of what contributed to the uptick in cases at MCA, roughly 50% of physician responses included a misunderstanding of the C diff protocol at MCA, specifically with regards to when testing should take place. These responses came from both attending physicians and residents. CONCLUSION: With these results, we conclude that one of the main issues affecting hospital acquired infections is staff education and when to test the sample. Therefore, we opted to create a infographic which would then be placed in high traffic areas, including the resident lounge and physician meeting room at the family medicine clinic. Through this infographic, we plan to better educate physicians about the MCA C diff testing criteria and to introduce our survey in one month to ensure that the information has been effectively relayed.

Original Publisher

HCA Healthcare Graduate Medical Education

Improving Clostridium Difficile detection at Medical City Arlington: A Quality Improvement Project



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