Allowing bedside nurses autonomy to order testing for clostridium difficile (C. diff) results in faster diagnostic turnaround times, which can reduce the risk of the deadly bacteria’s transmission, the authors of a new study say.
C. diff is a common cause of healthcare-associated infections. Nursing homes experience as many cases as do hospitals, with more than 100,000 estimated infections among residents each year, according to research from the Centers for Disease Control and Prevention.
The current study examined a policy change at a single-site Veterans Affairs Healthcare system. Bedside nurses were permitted to order stool samples for C. diff testing for symptomatic patients without a physician’s electronic signature. The goal was to gauge the effect on time lapse to obtain test results and initiate treatment. The researchers also tracked the frequency of orders.
Turnaround times reduced
After the policy change went into effect, the proportion of physicians and nurses ordering the tests was about the same. But nurse initiation of testing was associated with significantly faster turnaround times, the researchers found.
Speedier diagnostics likely helped to lower the risk of additional infections among patients and reduce the economic burden on the hospital, according to lead author Ashley Bartlett, MD, of the Fargo VA Healthcare System, Fargo, ND.
Early detection, along with other infection prevention measures, can greatly reduce related morbidity and mortality and prevent further transmission, she noted.
Incentives to change
“Given the implications of [C. diff infection] on both a hospital and patient level, incentives exist for improving approaches to the prevention and spread of this infection in the clinical environment,” Bartlett said in a statement. “Our findings suggest that allowing bedside nurses with appropriate training to order C. diff testing based on patient symptomology could be a valid strategy to help healthcare systems achieve this goal.”
Full findings were published in the American Journal of Infection Control.
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