Clostridium Difficile (C. difficile) is a bacteria-related gastrointestinal infection that is caused (etiology) by the use of antibiotics therapy or exposure to the C. difficile spores (Swartz, 2013). According to published reports compiled by the California Department of Public Health (CDPH), National Safety Network (NHSN), and the Center for Disease Control Prevention (CDC), the rate of CDI have a major financial impact (costs associated with medical management of CDI) on health care institution across the United States. CDI is major concern for hospital administrators and patients at Sharp Grossmont Hospital (SGH) and other in hospitals within the Sharp Healthcare Network (SHN). According to data released by CPDH and the CDC, from January to December 2012 three hospitals within the (SHN) reported 136 new cases of CDI. Statistical data also show that 20,000 to 34,000 patients were admitted or readmitted to the hospitals for recurrent complications related to CDI such as electrolyte imbalance, nutrition deficits, and systemic bacteremia (CDPH, 2013).
Fecal Microbiota Transplantation Program
According to Rohike and Stollman (2012), fecal microbiotic transplantation (FMT) first was used in 1958, as a treatment option for patients with antibiotic-associated diarrhea. However, the procedure was rarely performed or used in medical practice in the United States and in other countries. Because of increasing incidences and severity of CDI, FMT has gain acceptance as a quick and inexpensive treatment option (Brandt, 2012) for recurrent CDI. FMT involves the instillation of fecal material from a healthy individual into the intestinal track of a patient with recurrent CDI. Fecal material can be administered via endoscopy and colon...
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...ology & Hepatology, 8(3), 191-194.
* Swartz, T. (2013). Cutting C. diff by 70%. Healthcare Leadership Review, 32(11), 7-9. Retrieved from http://search.proquest.com/docview/1438641165?accountid=458
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Pathak, R., Enuh, H.A., Patel, A., & Wickremesinghe, P., (2013). Treatment of relapsing Clostridium difficile infection using fecal microbiota transplantation. Clinical and Experimental Gastroenterology, 2014 (7), 1-6.
*Rohike, F., & Stollman, N. (2012). Fecal microbiota transplantation in relapsing Clostridium difficile infection. Therapeutic Advances in Gastroenterology. 5 (6), 403-419.
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Clostridium difficile, otherwise known as C. diff, is a species of spore-forming, anaerobic, gram-positive bacteria that is known to cause watery diarrhea. 1 The genus name, Clostridium refers to the spindle shape of the organism while Difficile means difficult in Latin due to the fact that this organism thrives in unfavorable conditions and is very difficult to isolate.4 The incidence of getting CDI has increased over the years due to new strains of increased toxin production of the bacteria and increased resistance to antibiotics.2 It is a gastrointestinal infection, and the most common cause of infectious diarrhea.1 C. difficile was first identified in the feces of healthy newborns back in the 1930’s and by 1935, it was considered normal flora. 2 During 1974, researchers conducted that about 21% of patients that were treated with an antibiotic called clindamyacin reported diarrhea and about 10% of them reported to have conducted pseudomembranous colitis as a side effect of this treatment. 2 It was in 1978 where C. diff had been known to cause anti-biotic associated diarrhea and pseudomembranous colitis. 2 It is known to form spores that resist many disinfectants; it also survives for several months on different surfaces.1 It is a common form of a nosocomial infection and the prevalence of becoming infected with C. diff is about 0-15% in a health care setting. 3 The spores survive well in environments such as soil, water and animals and is distributed worldwide. 4 CDI produces two toxins (Toxin A and B), which are cytotoxic and cause tissue necrosis.4
According to the article The mechanism and efficacy of probiotics in the prevention of Clostridium difficile-associated diarrhea there is a great concern about increasing incidence of C. difficile infection due to use of broad spectrum antibiotics. Clindamycin, third generation of cephalosporins and flouroquinolones are considered high risk antibiotics. It is believed that normal gastrointestinal flora has potential effect in inhibition C.difficile growth and toxin A,B release which offen associated with sever diarrhea resulting in patient’s mortality and other comorbidities. After first episode, there is a high chance for relapses due to reduction serum IgG antibodies to toxin A and colonic IgA secretion cells.
A common hospital acquired condition that nurses see now days is clostridium difficile. This bacterium usually invades patients who have been on long-term antibiotics that have killed off bacteria that protect them from infection. C. diff is passed from host to host by both direct and indirect contact making it readily moved from patient to patient in hospital settings (Mayo, 2013, 1). Nurses can use the QSEN competencies and KSAs to help treat and prevent hospital acquired conditions such as C.diff.
Clostridium difficile infection usually occurs in people who are being treated with broad-spectrum antibiotics. The antibiotics kill all of the normal flora in the intestines leaving no bacteria to compete with C. difficile. It is then able to colonize and proliferate. It releases Toxin A and Toxin B. Toxin A is an ent...
Is fecal microbiota transplant (FMT) effective treatment for patients with Ulcerative Colitis (UC). UC is a chronic inflammation of the large intestine. FMT is used to describe the delivery of a healthy donors stool into a patient via enema, colonoscope, or nasogastric tube. In the past several years FMT has been used for an alternative treatment with patients diagnosed with Clostridium difficile (CD). The purpose of this paper is to discuss if FMT is just as effective in treating UC over just medication. The articles below will give insight if this theory is true or not.
applied probiotic capsules for bacterial vaginosis and other vaginal infections: a double-blind, randomized, placebo-controlled study. European Journal of Obstetrics & Gynecology and Reproductive Biology, 168(2013), 75-79. doi: 10.1016/j.ejogrb.2012.12.031p
CLABSIs are not confined to one unit of nursing care and there are many precipitating factors that may contribute to the development of a CLABSI. Often times these lines are placed in emergent situations in the emergency department (ED) and there may be a break in sterile technique. However a study conducted by Smith, Egger, Franklin, Harbrecht, and Richardson (2011) found a higher incidence of CLABSIs among intensive care unit (ICU) patients compared to those patients whose CLs were placed either in the ED or operating room (OR). This indicates further education for ICU s...
Human intestinal microflora is diverse and complex in nature affecting our health either positively or negatively.
Hospital acquired infections are one of the most common complications of care in the hospital setting. Hospital acquired infections are infections that patients acquired during the stay in the hospital. These infections can cause an increase in the number of days the patients stay in the hospital. Hospital acquired infections make the patients worse or even cause death. “In the USA alone, hospital acquired infections cause about 1.7 million infections and 99,000 deaths per year”(secondary).
This system provides annual statics on Medicare payment amounts for institutional providers. A nurse leader can use HCRIS to find other similar institutions with whom to compare reimbursement rates and use this information to make necessary adjustments (“Healthcare Cost Report”, 2016). Lastly, nurse leaders can also use cost-to-charge ratios, volume-based measures, per diem rates, and balanced scorecards to gain better insight of unit reimbursement (Liberty University,
C. difficile infection (CDI) is a dangerous healthcare-associated infection as well as a growing burden, especially with the appearance of more potent strains in the early 2000s. Clostridium difficile was initially identified as possessing the ability to initiate pseudomembranous colitis in the late 1970s. Asymptomatic colonization in healthy adults has been detected in only 3% of individuals, whereas the pervasiveness of such colonization among patients in long-term-care facilities is approximately 50%. People colonized with C. difficile act as a reservoir of contamination by infecting the environment with C. difficile spores, consequently leading to an increase of the pathogen in the hands of healthcare professionals or by way of medical equipment (Noorani, Soni, Pitrak, Belinson, & Aronson, 2012).... ... middle of paper ... ...
Deep within our gastrointestinal tract, known affectionately as the gut, exists a community like no other which helps maintain the essence of who we are and helps us maintain the balance us humans yearn and depend on to live. Bacteria, archaea, protists, fungi and viruses all interact around each other keeping the boring and uneventful that the body likes full of abundance. Upon some sort of shake up whether there are maleficent bacteria charging the intestinal landscape threatening to wipe out the community, or a change in the environment due to movement or destruction of the community members the microbiome’s ability to weather the storm and keep its intestinal home straight is essential. One of these shake ups, in the case of excessive antibiotic use through indirect infection, members of the intestinal microbiome community are wiped out and allow for Clostridium difficile, a normal inhabitant of the gastrointestinal landscape to thrive unchecked by the previous order and create a new dysfunctional world, creating a state of dysbiosis.
...d procedures are now being monitored to improve clinical processes. Ensuring that these processes are implemented in a timely, effective manner can also improve the quality of care given to patients. Management of the processes ensures accountability of the effectiveness of care, which, as mentioned earlier, improves outcomes. Lastly, providing reimbursements based on the quality of care and not the quantity also decreases the “wasting” and overuse of supplies. Providers previously felt the need to do more than necessary to meet a certain quota based on a quantity of supplies or other interventions used. Changing this goal can significantly decrease the cost of care due to using on the supplies necessary to provide effective, high-quality care. I look forward to this implementation of change and hope to see others encouraging an increase in high-quality healthcare.