Physicians, nurses disagree on when to test for C. diff: 11 risk factors

Physicians 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. Middleton Veterans Affairs Hospital in Madison, Wis., that included surveying 40 resident and attending physicians 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 factors, 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 factor ranking between physicians and nurses. Risk factors that physicians ranked as being significantly 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 important 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



More articles on C. diff:
Study examines economic burden of C. diff on hospitals
Leukemia patients at high risk for C. diff infections, study finds
Long Island hospital receives Pinnacle award for reducing C. diff

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