Better Communication, Coordination May Aid CDI Prevention at VA Hospitals

A national initiative to prevent Clostridioides difficile infections at Veterans Affairs (VA) facilities would benefit from better communication and less hierarchy, according to study findings published online ahead of print in the American Journal of Infection Control.

The study gauged perspectives of 29 frontline and key stakeholders about barriers and facilitators in the implementation of a C difficile infection (CDI) prevention initiative launched by the VA  Multidrug-Resistant Organism Program Office in 2012. The national initiative mandates use of a bundle of CDI prevention practices in inpatient VA facilities. 

Researchers interviewed the 29 personnel, including infection prevention and control leaders, nurses, physicians, and environmental management staff, at 4 sites between October 2019 and July 2021.

Infection prevention and control leaders were most likely to know specific components of the CDI prevention bundle, according to the study. Otherwise, the depth of awareness of specific practices among workers varied with their professional role.

Facilitators to sustained implementation of the CDI prevention bundle included leadership support, mandated training, mandated prevention practices, and readily available education from multiple sources, the study found.

Barriers to implementation included poor communication about CDI rates on units and in facilities, vague communication on practice updates, and role-based hierarchies that limit contributions from team members.

“Recommendations include improving centrally-mandated clarity about and standardization of CDI prevention policies, including testing,” researchers wrote. “Regular infection prevention and control training updates for all clinical stakeholders are also recommended.”

Reference: 
Parmasad V, Keating J, McKinley L, et al. Frontline perspectives of C. difficile infection prevention practice implementation within veterans affairs health care facilities: a qualitative study. Am J Infect Control. Published online March 26, 2023. doi:10.1016/j.ajic.2023.03.014