Previous Hospitalization as a Risk Factor for Clostridium difficile Infection

Previous hospitalization is associated with Clostridium difficile (C. diff) colonization, which can occur without symptoms, but may lead to an infection when immunities are compromised. Clostridium difficile Infection (CDI) is expensive to treat and is associated with extended hospitalization. The objective of this study was to determine the percentage of positive healthcare-onset C. diff patients with previous hospitalization, and identify the length of time between the patient’s last discharge date and current hospitalization. Neuman’s Systems Model, the conceptual model for this study, views the patient multi-dimensionally, focusing on preventing and managing stressors and responses to stressors. This study addressed secondary prevention by identifying risk factors for CDI. All inpatients at a tertiary care hospital system with a positive C. diff PCR test in the first quarter of 2015 were identified using Compass Pathfinder®. Only patients classified with hospital-associated C. diff were included, totaling 37 participants. A retrospective chart review collected data from Cerner PowerChart®. Data were analyzed using SPSS® Version 22. Approximately 70% of patients had a previous discharge. Fifty-four percent were discharged within the last year and 16.2% were discharged over a year ago. Among the 26 with previous discharges, 3 were noted to have a previous positive C. diff test. In conclusion, most positive health-care C. diff patients had a previous hospitalization. Implications include healthcare provider awareness of previous hospitalization as a risk factor for CDI. Opportunities exist to evaluate prior and current length of stay and the number of hospitalizations to assess the association with CDI