Clostridioides difficile order set increased appropriateness of testing, study finds
The smart order set, implemented in one health care system, put a hard stop on orders for Clostridioides difficile testing if patients admitted for more than four days had recently received laxatives or been treated or tested for C. difficile.
An order set improved the appropriateness of Clostridioides difficile testing, according to a recent retrospective analysis that compared testing for C. difficile before and after order-set implementation across a health care system. The smart order set put no restrictions on ordering C. difficile testing in patients who had been admitted for less than 96 hours. For patients in the hospital longer, three criteria had to be met to order a test: no laxatives had been administered within 48 hours, no treatment for C. difficile had been administered within 14 to 24 days, and the patient had not had a previous positive result within 14 days or a negative result within four days. The study, published June 27 by the American Journal of Infection Control, found that a higher proportion of tested patients had at least three watery or loose stools documented within a 24-hour period under the order set and that the rate of inappropriate stool testing decreased to 11.0% from 31.1%.
A more complete summary of the study is available in ACP Hospitalist, a publication exclusive to ACP members. Single sign-on is required.