C. difficile infection - a tool for improving practice and reducing rates.

Clostridium difficile infection (CDI) is a recognized health-care-acquired infection (HAI) and as such it is vital that hospitals do more to reduce the rates of infection. Patients, especially older people, become particularly susceptible to CDI after treatment with antibiotics. Mention of CDI on death certificates is increasing and surveillance, especially when accompanied by feedback to clinicians, has long been established as an effective tool to lower HAIs. In February 2008, a Manchester hospital began to pilot the Root Cause Analysis (RCA) tool for all patients confirmed with a CDI. After receiving feedback from clinicians on its appropriateness and suitability, the RCA tool was amended accordingly and then implemented into practice. The RCA tool has significantly improved practice and collaborative working - it has enhanced teamwork and ultimately reduced infection. This article examines how the tool was embedded in the Trust, how the change process has been managed and ultimately, how patient care has benefited as a result.