Healthcare Associated Infections

Clostridium difficile Programs

C.difficile Prevention Partnership Collaborative

C. difficile Prevention Partnership Collaborative Final Workshop June 22, 2012
Announcement and Agenda

Presentations

• CDI Prevention Partnership Collaborative Opening Slides, Paula Griswold, MS, Massachusetts Coalition for the Prevention of Medical Errors
• Sharing Exercise: Mad Hatter Tea Party, Sharon Benjamin, PhD., Alchemy
• Antimicrobial Stewardship: A Team Approach at Milford Regional Medical Center, Kim Knox, MHA, RN, CIC, Milford Regional Medical Center
• C. difficile Reduction: A Team Approach from Salmon Health and Retirement & Beaumont Rehabilitation and Skilled Nursing Center, Cindy Foss, RN, and Nicole Croteau, RN, Beaumont Nursing Home
• Discovery and Action Dialogues, Sharon Benjamin, PhD., Alchemy
• CDI Collaborative: Our Journey 11/11 to Present, Merrimack Health Group & Marlborough Hills Health Care Center, Karen Tremblay, RN: Marlborough Hills, Julie Drummond, RN: TCU at Hubbard, Michael Lincoln: Marlborough Hills
• CDI Collaborative: Northeast Health Systems & Seacoast Nursing and Rehabilitation Center, Lila Bareford RN, CIC, BSN: Northeast Health System, Kathy Evans, LPN: Seacoast Nursing and Rehabilitation
• C. difficile Prevention Partnership Collaborative: Bringing Together Hospitals & Nursing Facilities,Sharon Benjamin, PhD., Alchemy
• Infection Prevention and Control Challenges for Long-term Care, Phenelle Segal, RN, CIC, Infection Control Consulting Services, LLC

Handouts

• Table of Contents from the C. difficile Prevention Collaborative November 15, 2011 Toolkit
• Practice Opportunities for C. difficile Prevention for Hospitals and Skilled Nursing Facilities
• Merrimack Health Group Hand Washing and CDI Needs Assessment Form
• Seacoast Nursing and Rehabilitation Center Nurse-to-Nurse form
• Baystate Medical Center Partnership Survey #1: Hand Hygiene, Cleaning and Disinfection, Isolation
• Baystate Medical Center Partnership Survey #2

Hospital Collaborative & Team Workshops: C. difficile Prevention Partnership Collaborative Workshop: Improving Drug Use to Enhance Infection Prevention: Antibiotic Stewardship and Beyond April 30, 2012 (Newton, MA) and May 16, 2012 (Sturbridge, MA)
Program Announcement

Regional Workshops � April 30, 2012 and May 16, 2012 are the same program made available in two areas of Massachusetts

Faculty

• Susanne Salem-Schatz, Sc. D, and Paula Griswold, MS, Massachusetts Coalition for the Prevention of Medical Errors
• Tina Gabarowski, NP, Countryside Health Care of Milford
• Ruth Kandel, MD Hebrew Senior Life and Harvard Medical School
• Jennifer Schimmel, MD, Infectious Diseases and Antimicrobial Stewardship, Baystate Medical Center

Presentations

• Opening Slides and Overview � Susanne Salem-Schatz, Sc. D, and Paula Griswold, MS, Massachusetts Coalition for the Prevention of Medical Errors
• Screening Tool for UTI�s - Attempting to reduce the unnecessary use of antibiotics, Tina Gabarowski, NP, Countryside Health Care of Milford
• To Treat or Not to Treat � That is the Question, Ruth Kandel, MD Hebrew Senior Life and Harvard Medical School
• UTI 101: Antimicrobial Agents, Duration and Prophylaxis, Jennifer J. Schimmel, MD, Baystate Medical Center, Div. Infectious Diseases and Antimicrobial Stewardship
• Importance of Communication about Antibiotic Use, Susanne Salem-Schatz, Sc. D, Massachusetts Coalition for the Prevention of Medical Errors

Handouts

• Optimal Management of UTI Beveridge
• Interfacility Transfer Communications Form
• Patient Brochure for Massachusetts – Appropriate Antibiotic Use
• SBAR UTI
• CDC � 12 Steps to Prevent Antibiotic Resistance in Long Term Care
• CDC � Get Smart
• Antibiotic Stewardship Workshop Reference List

REGIONAL WORKSHOP: Newton, MA: April 30th 8AM-Noon; Repeated: Sturbridge, MA: May 16th

• Feasible stewardship strategies for acute and long term care providers
• Reducing overuse with UTI: Diagnosis and treatment of UTI in acute and long term care, including useful strategies and tools
• Improving communication about medications, indications, and infection history on transfer between facilities

Faculty:

• Tina Gabarowski, NP, Countryside Health Care of Milford
• Ruth Kandel, MD Hebrew Senior Life and Harvard Medical School
• Jennifer Schimmel, MD, Infectious Diseases and Antimicrobial Stewardship, Baystate Medical Center

Audience: Staff and consultants from facilities in the CDI Prevention Partnership Collaborative

Acute care: pharmacists, hospitalists, infectious disease specialists, infection preventionists, case managers responsible for care transitions.

Long term care: medical directors, nurse practitioners, consulting pharmacists, staff development coordinator or educator, social worker or staff in charge of transfers, infection prevention and front line nurses

Regional Team Workshops January, 2012
Workshops Announcement and Agenda

• Learn how hospital / SNF clusters in your area are working together
• Learn techniques to engage front line staff as active participants in infection prevention
• Work with colleagues to:
  1. develop an approach to communication around transfers between facilities;
  2. discuss best practices in environmental cleaning and disinfection as well as strategies for implementation; and
  3. identify contact precautions and isolation strategies that can work for your facility and residents / patients.

Workshops Held (January 24th , 25th , 26th , 31st , 2012) at:

• Lowell General Hospital
• Baystate Medical Center
• Jordan Hospital
• UMASS Memorial Medical Center

Presentations — Click here to download Adobe Acrobat file of all presentations listed below.

• Table Talk: What have you noticed? What have you changed?
• Engaging Everyone in Finding Solutions
  • Engaging frontline staff in identifying and making improvements to prevent transmission of C.difficile infection
    • Implementing precautions
    • Environmental cleaning and disinfection
    • Communication about infections at time of inter-facility transfer
• Small Tests of Change
  • Using quality improvement to test and implement changes to prevent C.difficile infection

Handouts

• Toolkit Table of Contents (Click here to see November 15, 2011 program Handout section to access documents on this list)
• Practice Opportunities for C.difficile Prevention
• Inter-Facility Infection Control Transfer Form
• PDSA Worksheet
• Discovery and Action Cheat Sheet

C.difficile Prevention Workshop November 15, 2011
Program Announcement and Agenda

Presentations

• Nov. 15 2011 Introduction
• Looking at Our Results - Focus on Change
• What Works - Successful Strategies from Collaborative Participants - Part I
• What Works - Successful Strategies from Collaborative Participants - Part II
• Partnership Collaborative Launch
• Clostridium difficile Management in Healthcare Facilities

Faculty/Program Committee

• Paula Griswold, MS, MA Coalition for the Prevention of Medical Errors
• Susanne Salem Schatz, ScD, MA Coalition for the Prevention of Medical Errors
• Sharon Benjamin, PhD, Alchemy
• Gail Bennett, MSN, RN, CIC, ICP Associates, Inc.
• Laurie Herndon, MSN, GNP-BC, ANP-BC
• Helen Magliozzi, RN, MA Senior Care Foundation
• Alfred DeMaria, MD, Medical Director, Bureau of Infectious Disease, Prevention, Response and Services; State Epidemiologist, Massachusetts Department of Public Health

Handouts

• Mass CDI Collaborative Hospital - How Did We Do through Sept 2011 – Blinded Run Charts
• MA CDI Rates per 10,000 patient days
• What We Know About Creating Change
• Practice Opportunities Worksheet for Hospitals and SNFs
• PDSA Worksheet
• Learning Visit Notes

Toolkit Table of Contents

CDI Prevention Guidelines and Policies

• APIC / SHEA Guideline: Infection prevention and control in the long term care facility Clinical Practice Guidelines for Clostridium difficile
• Infection in Adults: 2010 Update by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA)
• Clostridium difficile and Clostridium-difficile associated disease Infection Control Guidelines for Long-Term Care Facilities Massachusetts Department of Public Health Division of Epidemiology and Immunization
• APIC Guide to the Elimination of C. Difficile in Health Care Settings
• Northeast Hospitals Corporation CDI Bundle Program
• Harrington Hospital Clostridium Difficile Policy
• Harrington C difficile Treatment Guidelines

APIC New England Presentations by CDI Prevention Collaborative Teams

• Cooley Dickinson Hospital – APIC Presentation – Environmental Services-Microsystems Team – October 2011
• Noble Hospital – APIC Presentation – Cdiff Reduction Utilizing an Interdepartmental Team Approach
• St. Vincent Hospital – "No Butts About It, Let"s Wipe it Away"

Patient Assessment and Testing

• National Health Service (Bristol) Stool Chart
• Baron BM Chart for C. difficile Assay (Harrington Hospital)
• C. difficile Testing Guidance (Massachusetts DPH)

Patient Placement

• Centers for Disease Control 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings: Web address
• Southcoast Hospitals C. difficile Isolation Algorithm

Patient and Family Education

• Centers for Disease Control CDI FAQs
• Centers for Disease Control CDI FAQs Spanish
• New England Baptist Hospital C. Difficile Patient Information Sheet
• New England Baptist Hospital Contact Precautions Visitor Instructions
• New England Baptist Hospital Patient and Family Hand Hygiene Brochure

Hand Hygiene

• Centers for Disease Control Hand Hygiene Guidelines in Healthcare Settings
• CDC Hand Hygiene Screen Shot
• World Health Organization 5 Moments for Hand Hygiene Poster
• Ontario "Just Clean Your Hands" Program
• JCAHO "Targeted Tools" for Hand Hygiene (web resources)
• Cooley Dickinson Hospital Hand Washing Bathroom Reminder Sign
• New England Baptist Hospital C. difficile Hand Hygiene poster
• Saint Vincent Hospital Hand Hygiene Monitoring Guideline
• Saint Vincent Hospital Hand Hygiene Monitoring Tool
• Saint Vincent Hospital Got Hands? Little Boy Hand Hygiene Poster
• Saint Vincent Hospital Got Paws Kitten Hand Hygiene Poster
• Baystate Franklin "Have you been spotted?" Poster
• Baystate Franklin Hand Hygiene Raffle Ticket

Contact Precautions

• Centers for Disease Control Graphics for Donning and Removing PPE
• Cooley Dickinson Hospital Precautions Sign  with List of Conditions that Require Precautions
• Cape Cod Hospital Enteric Precautions Sign
• Marlborough Hospital Transport Form "Ticket to Ride"
• Harrington Hospital Contact Precautions Plus Sign
• Noble Hospital Contact Precautions for C. Difficile Sign

Cleaning and Disinfection of Equipment and Environment

• Centers for Disease Environmental Infection Control in Health Care Facilities
• Centers for Disease Control Cleaning Checklist (adapted)
• CDI Cleaning Bundle Strategies (Pennsylvania Improvement Collaborative)
• Cooley Dickinson Hospital 9 Step Cleaning Process
• Cape Cod Hospital Combination Cleaning and Disinfectant Products Guide
• Franciscan Hospital for Children Cleaning of Reusable Patient Care Equipment Policy
• Research, EBP, Quality Improvement : Fairview Hospital Slide Presentation on the Switch to Micro Fiber Mops

Antibiotic Stewardship

• Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America Guidelines for Developing an Institutional Program to Enhance Antimicrobial Stewardship Clinical Infectious Diseases 2007; 44:159�77
• MetroWest Medical Center �Dear Doctor� Letter
• MetroWest Medical Center P&T Fluoroquinolone Alternative Recommendations

Patient Transfer Communication

• Centers for Disease Control Interfacility Transfer Communication Form
• Tewksbury Hospital Communication with Referring Facilities

Measurement

• Partnership Collaborative CDI Measure Definitions
• Clostridium difficile Line Listing Sheet
• New England Sinai Hospital and Rehabilitation Center Hand Hygiene and PPE Observation Form

Process Improvement Tools

• C. difficile Cause Analysis Tool (from CDI Prevention Collaborative 2010-2011)
• Baystate Medical Center �Fishbone� Cause Analysis Tool
• PDSA Planning Tool

Hospital C.difficile Prevention Collaborative

C. diff Prevention Collaborative Hospital Team Workshop
March 29, 2011 Program Announcement and Agenda

Presentations

• Ten Months In: What Have We Accomplished and What's Next
  Paula Griswold, Susanne Salem Schatz - MA Coalition
• C.diff Reduction Utilizing an Interdepartmental Team Approach
  Mary Jane Lamb, Susan St. - Jean Noble Hospital
• No Butts About It, Lets Wipe It Away
  Debra Berube, St. Vincents Hospital
• C.diff Improvement Work
  Sue Valentine - Harrington Hospital
• Environmental Services Leaders in Infection Prevention
  Daniel English, Linda Riley - Cooley Dickinson Hospital
• C.difficile Screening and Identification Myths: fact or fiction
  Lisa Davidson - Tufts University School of Medicine
• Antimicrobial Stewardship: An Important Piece of the Puzzle to Improving Patient Outcomes and Reducing Healthcare Associated Infections (Large file 5.3M, this may download as a .zip file)*
  Kenneth Lawrence - Tufts Medical Center
• Antibiotic Stewardship at MetroWest Medical Center
  Colleen Grocer - MetroWest Medical Center
• Quinolone Restriction
  Vibha Sharma Tim Yang - Marlborough Hospital
• A Team Approach to Antibiotic Stewarship
  Jeffrey Powis Yves Crehore Sue Gill - Toronto East General Hospital

C. diff Prevention Collaborative Team Workshop
June 24, 2010 Program Announcement and Agenda

Presentations

• Introduction and Next Step Slides
  Paula Griswold, Susanne Salem-Schatz - MA Coalition
• Preventing Transmission of C. diff: Principles of Prevention
  Carolyn Gould - Centers for Disease Control
• Optimizing Environmental Hygiene: The Key To C. diff Control
  Phil Carling, MD - Carney Hospital
• Preventing Transmission Of C.difficile: Practice
  Elise Tamplin - Brigham & Womens Hospital
• Using Measurement To Inform And Improve
  Maureen Spencer - N.E. Baptist Hospital
• Building on Patient Safety: C. diff Practice Opportunities
  Mary Ellen Scales - Bay State Medical Center
• Learning Our Way To Improvement: Pulling It Together
  Susanne Salem-Schatz - MA Coalition
• How Huddles Improved Hand Hygiene and Reduced VRE
  Colleen Zidik, Rebecca Spitz, Jeanne Barton, Susan ORourke, Miriam Perez- Brigham & Women’s Hospital
• Front-line Staff: a Force for Excellence in Reducing Hospital Acquired Infections
  Karen Peters, Pamela Linzer, Stephanie Foster, Alison Barbush, Katie Marshall - Winchester Hospital
• Turning Corners Across the Border in Eliminating C-Diff
  Tracey Fletcher - University Health Network, Toronto Western Hospital
  Liz Rykert - Ontario Agency for Health Protection and Control
• Practice Using Conversation for Improvement
  Sharon Benjamin - Alchemy & Plexus Institute

Tools

• Baystate Medical Center C.diff Algorithm
• Huddle Checklist Improving Hand Hygiene Reduce VRE
• PDSA Planning Worksheet
• Practice Assessment Planning Chart
• Sample Practice Planning Worksheet
• Practice Planning Worksheet
• Action Steps When Diarrhoea Diagnosed C.diff Stool Chart
• C.diff Measure Collaborative Definition
• Practice Opportunities for C.diff Prevention

Resources

• Clinical Practice Guidelines for C.diff in Adults ICHE May 2010
• Does My Patient Have C.diff? Annals 2009
• Guidelines for Developing Program to Enhance Antibiotic Stewardship

Audio Conferences

C. difficile Prevention Partnership Collaborative Coaching Call: Improving Drug Use to Enhance Infection Prevention: Antibiotic Stewardship and Beyond April 25, 2012 Program Announcement

Faculty

• Shira Doron, MD, Geographic Medicine and Infectious Disease, Tufts Medical Center
• David Goldwater, Pharm BSc. R. Ph Clinical Consultant, Partners Pharmacy of Massachusetts, LLC
• Terrence O�Malley, MD, CMD, Medical Director Non-Acute Care Services, Partners Health System
• Erica Tenholder, Pharm.D, BCPS, Clinical Pharmacy Specialist for Infectious Diseases and Antimicrobial Stewardship, Baystate Medical Center

Presentations

• Antibiotic Stewardship and Beyond Audio Conference Call Presentations

C. difficile Prevention Partnership Collaborative Coaching Call: C. difficile Management in Healthcare Facilities
January 19, 2012

Featuring: Phenelle Segal, RN CIC, President, Infection Control Consulting Services

Presentation

C. difficile Prevention Partnership Collaborative Coaching Call
December 8, 2011

Presentation

• December 8 Coaching Call slides

C. diff Prevention Collaborative
November 9, 2011

Team Discussion No Slides

C. difficile Prevention Collaborative Monthly Team Coaching Call
September 21, 2011

Featuring:
Jane Taylor, Ed.D

Presentation

C. difficile Prevention Collaborative Monthly Coaching Call
July 19, 2011

Tools

• Baystate CDI Fishbone
• CDI Cause Analysis
• Milford CDIFF Cause Analysis Spreadsheet

CDI Prevention Collaborative Call for Teams
October 13, 2010

Presentation

• Using Root Cause Analysis to Tackle C.difficile Infections
  Tony Maggs - Torbay Hospital, National Health Service

Tools and Resources

• New Adverse Event Risk Assessment Form (MRSA Screen)
• Session 4 Root Cause Analysis
  • C.diff Standard Practices
  • Outcome Report
  • C.diff Briefing
  • C.diff Trigger Questions

C. diff Prevention Collaborative Kick-off call for Teams
June 2, 2010 Program Announcement

Presentation

Leadership

C. difficile Prevention Partnership Collaborative Leadership Call
January 4, 2012

Featuring

• Doreen Hutchinson, RN, Vice President of Operations and Chief Nursing Office, Fairview Hospital
• Ellen Candlish, Director of Nursing, Laurel Lake Center for Health and Rehabilitation

Presentation

• January 4 2012 leadership call

C. diff Prevention Collaborative Kick-off call for Hospital Senior Leaders
May 4, 2010 Program Announcement

Presentations

• Infection Prevention Strategies for Success
  Mairead Hickey Brigham & Womens Hospital
• Role of the Executive Sponsor: Reflections from Winchester Hospital
  Richard Iseke Winchester Hospital

*This file may download as a .zip file. Please contact macoalition@macoalition.org with any questions.

Click here to download the Adobe Acrobat Reader®.