Sustained reduction in rates of hospital-onset Clostridium difficile infection using an automated electronic health record protocol.

Background: An automated protocol was designed within our electronic medical record (EMR) to help curb the Clostridium difficile problem at our institution. The protocol will identify patients at high risk for C difficile, improve the timing of testing of patients infected on admission, and enhance the appropriateness of C difficile testing throughout the patient's hospitalization.

Methods: Admitted patients with 2 of the following 3 criteria were labeled as high risk for C difficile: admission to a medical institution in the preceding 90 days, administration of antibiotics in the preceding 90 days, or a history of C difficile.

Alpha-defensin-novel synovial fluid biomarker for the diagnosis of periprosthetic joint infection.

Purpose: Periprosthetic joint infection (PJI) continues to be a significant complication after total joint arthroplasty. Diagnosis of PJI can be challenging and elusive in the absence of a gold standard. This purpose of this article is to review the current evidence on the utility of serum and synovial fluid biomarkers to help aid in the diagnosis of PJI with focusing on synovial fluid alpha-defensin.

Hospital hand hygiene compliance improves with increased monitoring and immediate feedback.

Background: Health care-associated infections are serious complications impacting 2 million patients and accounting for approximately 100,000 deaths per year. In the present study, we evaluated the effectiveness of a new hand hygiene monitoring program (HHMP) and measured the sustainability of this effectiveness over a 1-year period.

Methods: The HHMP consisted of 4 key components: extensive education, conspicuous and visible monitors, immediate feedback concerning compliance to health care workers, and real-time data dissemination to leadership.

Effectiveness and cost of failure mode and effects analysis methodology to reduce neurosurgical site infections.

Mercy Hospital Springfield is a tertiary care facility with 32 000 discharges and 15 000 inpatient surgeries in 2011. From June 2009 through January 2011, a stable inpatient elective neurosurgery infection rate of 2.15% was observed.