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Journal of General Internal Medicine
Published in: Journal of General Internal Medicine 1/2019

01-01-2019 | Concise Research Reports

Use of Computerized Clinical Decision Support for Diagnostic Stewardship in Clostridioides difficile testing: an Academic Hospital Quasi-Experimental Study

Authors: Anne E. Friedland, MD, Sara Brown, MD, Danielle R. Glick, MD, Martha C. Lusby, RN, BSN, Daniel Lemkin, MD, Surbhi Leekha, MBBS, MPH

Published in: Journal of General Internal Medicine | Issue 1/2019

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Excerpt

Overdiagnosis of Clostridioides difficile as a cause of healthcare-associated diarrhea is a prevalent problem in the USA due to increasing use of highly sensitive nucleic acid amplification tests, combined with a low threshold for testing of patients in the absence of significant diarrhea and in the presence of laxatives.1‐3 Others have reported on efforts at reducing unnecessary C. difficile testing through computerized clinical decision support (CCDS), with variable results.4, 5 We conducted a quasi-experimental study to evaluate the impact of CCDS on appropriateness of C. difficile testing. …
Literature
1.
Rock C, Pana Z, Leekha S, Trexler P, Andonian J, Gadala A, Carroll KC, and Maragakis LL; CDC Prevention Epicenters Program. National Healthcare Safety Network laboratory-identified Clostridium difficile event reporting: a need for diagnostic stewardship. Am J Infect Control. 2018;46:456–458.CrossRef
2.
Kelly SG, Yarrington M, Zembower TR, Sutton SH, Silkaitis C, Postelnick M, Mikolajczak A and Bolon MK. Inappropriate Clostridium difficile Testing and Consequent Overtreatment and Inaccurate Publicly Reported Metrics. Infect Control Hosp Epidemiol. 2016;37:1395–1400.CrossRef
3.
Kinlay J and Sandora TJ. A qualitative study to identify reasons for Clostridium difficile testing in pediatric inpatients receiving laxatives or stool softeners. Am J Infect Control. 2017;45:539–541.CrossRef
4.
White DR, Hamilton KW, Pegues DA, Hanish A and Umscheid CA. The Impact of a Computerized Clinical Decision Support Tool on Inappropriate Clostridium difficile Testing. Infect Control Hosp Epidemiol. 2017;38:1204–1208.CrossRef
5.
Madden GR, German Mesner I, Cox HL, Mathers AJ, Lyman JA, Sifri CD and Enfield KB. Reduced Clostridium difficile Tests and Laboratory-Identified Events With a Computerized Clinical Decision Support Tool and Financial Incentive. Infect Control Hosp Epidemiol. 2018;39:737–740.CrossRef
6.
Rock C, Mizusawa M, Small B, Hsu Y, Kauffman C, Trivedi J, Landrum B, Feldman L, Pahwa A, Carroll KC and Maragakis LL. Implementation of Electronic Medical Record Hard Stop Alerts for Inappropriate Clostridium difficile Tests in Academic and Community Hospital Setting; Impact on Testing Rates and Clinical Outcomes. Open Forum Infect Dis. 2017;4 (Suppl 1):S608CrossRef
Metadata
Title
Use of Computerized Clinical Decision Support for Diagnostic Stewardship in Clostridioides difficile testing: an Academic Hospital Quasi-Experimental Study
Authors
Anne E. Friedland, MD
Sara Brown, MD
Danielle R. Glick, MD
Martha C. Lusby, RN, BSN
Daniel Lemkin, MD
Surbhi Leekha, MBBS, MPH
Publication date
01-01-2019
Publisher
Springer US
Published in
Journal of General Internal Medicine / Issue 1/2019
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-018-4659-4

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