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20 Infection Prevention & Control P hysicians and nurses don't seem to agree on which risk factors are considered most important when determining whether or not to test patients for Clostridium difficile, according to a study published in the American Journal of Infection Control. Researchers conducted a study at William S. Middle- ton Veterans Affairs Hospital in Madison, Wis., that included surveying 40 resident and attending physi- cians and 13 registered nurses. The surveys required the clinicians to rank the importance of various risk factors prior to testing for C. diff (on a five-point scale, with five being the most important). They surveyed physicians and nurses generally agreed on the importance of a few C. diff risk fac- tors, including: 1. Currently receiving high-risk antibiotic Average physician rank: 4.9 Average nurse rank: 4.9 2. Has had CDI previously Average physician rank: 4.7 Average nurse rank: 4.4 3. Recently completed antibiotic therapy with any antibiotic Average physician rank: 4.6 Average nurse rank: 4.3 4. Has had three or more partially formed or watery stools in the last 24 hours Average physician rank: 4.1 Average nurse rank: 4.1 There were also significant differences in risk fac- tor ranking between physicians and nurses. Risk factors that physicians ranked as being signifi- cantly more important than nurses include: 5. Currently in ICU Average physician rank: 4 Average nurse rank: 2.6 6. Current sepsis syndrome Average physician rank: 4.2 Average nurse rank: 2.8 7. Was recently hospitalized Average physician rank: 4.4 Average nurse rank: 3.1 8. Current fever of 102 degrees Fahrenheit or higher Average physician rank: 4.2 Average nurse rank: 2.9 9. Appears acutely ill Average physician rank: 4.4 Average nurse rank: 3.1 Risk factors ranked as significantly more impor- tant to nurses include: 10. Reports abnormal stool color Average physician rank: 2.5 Average nurse rank: 3.8 11. Reports abnormal stool odor Average physician rank: 2.8 Average nurse rank: 4 n Physicians, Nurses Disagree on When to Test for C. diff: 11 Risk Factors By Shannon Barnet Where are C. diff Rates Highest in the US? By Heather Punke O ver the last 10 years, rates of Clostridium difficile infections were highest in the Northeast region of the U.S., according to a study in the American Journal of Infection Control. Researchers from the University of Texas examined 2.3 million cases of C. diff infections from 2001-2010. In the Northeast, there ware 8 CDI discharges per 1,000 total discharges in that timeframe. The Mid- west followed with 6.4 CDI discharges per 1,000 total, then the South (5/1,000) and the West (4.8/1,000). However, C. diff mortality was highest in the Midwest (7.3 percent). Researchers also found that spring had the most cases of C. diff in- fections, with 6.2 CDI discharges per 1,000 total. Winter and sum- mer came next (both at 5.9/1,000) with fall bringing up the rear (5.6/1,000). "The peak incidence in the spring could be attributed to increased utilization of antibiotics in winter months," the study authors wrote. "Prior studies have found a one to two month lag time between anti- biotic exposure and the development of CDI." n SAVE THE DATE learn more & register at https://www.regonline.com/22ndAnnualASC October 22 - 24, 2015 Swissôtel - Chicago, Illinois Becker's ASC 22nd Annual Meeting The Business and Operations of ASCs 51 Great Surgeons, 55 Leading Administrators and 110 Surgery Center Speakers in Total