Clostridium Difficile Infection on an Inpatient Rehabilitation Unit - Quality Improvement Project

Our Continuous Quality Improvement (CQI) project was focused on modifiable risk factors associated with Clostridium difficile infection (CDI) with ultimate goal to reduce CDI on the inpatient rehabilitation unit (IMR). The incidence of C. Diff on the rehabilitation unit was 7 case per year leading up to the start of the project in 2014. Our project included three major interventions: education, appropriate antibiotic prescription and minimizing proton pump inhibitor use. Development of IMR UTI guideline resulted in a significant reduction of utilization of fluoroquinolones on the IMR (high-risk antibiotics for CDI) and promoted use of more appropriate empiric antibiotics based on IMR Antibiogram. Preliminary data is suggestive of a trend in discontinuation of PPI on IMR, which is likely attributed to our educational intervention as well as implementation of Thera-Doc alerts system. Development of PPI guideline for IMR is pending.