Clostridium Difficile (C. difficile) is a bacteria-related gastrointestinal infection that is caused (etiology) by the use of antibiotics therapy or exposure to the C. difficile spores (Swartz, 2013). According to published reports compiled by the California Department of Public Health (CDPH), National Safety Network (NHSN), and the Center for Disease Control Prevention (CDC), the rate of CDI have a major financial impact (costs associated with medical management of CDI) on health care institution across the United States. CDI is major concern for hospital administrators and patients at Sharp Grossmont Hospital (SGH) and other in hospitals within the Sharp Healthcare Network (SHN). According to data released by CPDH and the CDC, from January to December 2012 three hospitals within the (SHN) reported 136 new cases of CDI. Statistical data also show that 20,000 to 34,000 patients were admitted or readmitted to the hospitals for recurrent complications related to CDI such as electrolyte imbalance, nutrition deficits, and systemic bacteremia (CDPH, 2013).
Fecal Microbiota Transplantation Program
According to Rohike and Stollman (2012), fecal microbiotic transplantation (FMT) first was used in 1958, as a treatment option for patients with antibiotic-associated diarrhea. However, the procedure was rarely performed or used in medical practice in the United States and in other countries. Because of increasing incidences and severity of CDI, FMT has gain acceptance as a quick and inexpensive treatment option (Brandt, 2012) for recurrent CDI. FMT involves the instillation of fecal material from a healthy individual into the intestinal track of a patient with recurrent CDI. Fecal material can be administered via endoscopy and colon...
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...ology & Hepatology, 8(3), 191-194.
* Swartz, T. (2013). Cutting C. diff by 70%. Healthcare Leadership Review, 32(11), 7-9. Retrieved from http://search.proquest.com/docview/1438641165?accountid=458
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Pathak, R., Enuh, H.A., Patel, A., & Wickremesinghe, P., (2013). Treatment of relapsing Clostridium difficile infection using fecal microbiota transplantation. Clinical and Experimental Gastroenterology, 2014 (7), 1-6.
*Rohike, F., & Stollman, N. (2012). Fecal microbiota transplantation in relapsing Clostridium difficile infection. Therapeutic Advances in Gastroenterology. 5 (6), 403-419.
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Clostridium difficile, otherwise known as C. diff, is a species of spore-forming, anaerobic, gram-positive bacteria that is known to cause watery diarrhea. 1 The genus name, Clostridium refers to the spindle shape of the organism while Difficile means difficult in Latin due to the fact that this organism thrives in unfavorable conditions and is very difficult to isolate.4 The incidence of getting CDI has increased over the years due to new strains of increased toxin production of the bacteria and increased resistance to antibiotics.2 It is a gastrointestinal infection, and the most common cause of infectious diarrhea.1 C. difficile was first identified in the feces of healthy newborns back in the 1930’s and by 1935, it was considered normal flora. 2 During 1974, researchers conducted that about 21% of patients that were treated with an antibiotic called clindamyacin reported diarrhea and about 10% of them reported to have conducted pseudomembranous colitis as a side effect of this treatment. 2 It was in 1978 where C. diff had been known to cause anti-biotic associated diarrhea and pseudomembranous colitis. 2 It is known to form spores that resist many disinfectants; it also survives for several months on different surfaces.1 It is a common form of a nosocomial infection and the prevalence of becoming infected with C. diff is about 0-15% in a health care setting. 3 The spores survive well in environments such as soil, water and animals and is distributed worldwide. 4 CDI produces two toxins (Toxin A and B), which are cytotoxic and cause tissue necrosis.4
According to the article The mechanism and efficacy of probiotics in the prevention of Clostridium difficile-associated diarrhea there is a great concern about increasing incidence of C. difficile infection due to use of broad spectrum antibiotics. Clindamycin, third generation of cephalosporins and flouroquinolones are considered high risk antibiotics. It is believed that normal gastrointestinal flora has potential effect in inhibition C.difficile growth and toxin A,B release which offen associated with sever diarrhea resulting in patient’s mortality and other comorbidities. After first episode, there is a high chance for relapses due to reduction serum IgG antibodies to toxin A and colonic IgA secretion cells.
A common hospital acquired condition that nurses see now days is clostridium difficile. This bacterium usually invades patients who have been on long-term antibiotics that have killed off bacteria that protect them from infection. C. diff is passed from host to host by both direct and indirect contact making it readily moved from patient to patient in hospital settings (Mayo, 2013, 1). Nurses can use the QSEN competencies and KSAs to help treat and prevent hospital acquired conditions such as C.diff.
CLABSIs are not confined to one unit of nursing care and there are many precipitating factors that may contribute to the development of a CLABSI. Often times these lines are placed in emergent situations in the emergency department (ED) and there may be a break in sterile technique. However a study conducted by Smith, Egger, Franklin, Harbrecht, and Richardson (2011) found a higher incidence of CLABSIs among intensive care unit (ICU) patients compared to those patients whose CLs were placed either in the ED or operating room (OR). This indicates further education for ICU s...
Among hospitalized patients around the world, Clostridium difficile is the primary source of infectious diarrhea. Previously, continuously unbalanced intestinal microbiota, usually due to antimicrobials, was deemed a precondition of developing the infection. However, recently, there have been alterations in the biology from virtually infecting the elderly population exclusively, wherein the microbiota in their guts have been interrupted by antimicrobials, to currently infecting individuals within of all age groups displaying no recent antimicrobial use. Furthermore, recent reports have confirmed critical occurrences among groups previously assumed to be of minimal risk—pregnant women, children, and individuals with no previous exposure to antimicrobials, for instance. Unfortunately, this Gram-positive, toxin-producing anaerobic bacterium is estimated to cost US critical care facilities $800 million per year at present, suggesting the need for effective measures to eliminate this nosocomial infection (Yakob, Riley, Paterson, & Clements, 2013).
Is fecal microbiota transplant (FMT) effective treatment for patients with Ulcerative Colitis (UC). UC is a chronic inflammation of the large intestine. FMT is used to describe the delivery of a healthy donors stool into a patient via enema, colonoscope, or nasogastric tube. In the past several years FMT has been used for an alternative treatment with patients diagnosed with Clostridium difficile (CD). The purpose of this paper is to discuss if FMT is just as effective in treating UC over just medication. The articles below will give insight if this theory is true or not.
...s of normal flora in the intestines causing more competition for space making it hard for C. difficile to flourish. The intestine is put back into homeostasis. The risk for problems associated with antimicrobial use like the development of antimicrobial resistant bacteria are decreased or completely eliminated with the use of stool transplantation making it an effective treatment for Clostridium difficile infection.2
applied probiotic capsules for bacterial vaginosis and other vaginal infections: a double-blind, randomized, placebo-controlled study. European Journal of Obstetrics & Gynecology and Reproductive Biology, 168(2013), 75-79. doi: 10.1016/j.ejogrb.2012.12.031p
This system provides annual statics on Medicare payment amounts for institutional providers. A nurse leader can use HCRIS to find other similar institutions with whom to compare reimbursement rates and use this information to make necessary adjustments (“Healthcare Cost Report”, 2016). Lastly, nurse leaders can also use cost-to-charge ratios, volume-based measures, per diem rates, and balanced scorecards to gain better insight of unit reimbursement (Liberty University,
Human intestinal microflora is diverse and complex in nature affecting our health either positively or negatively.
Hospital acquired infections are one of the most common complications of care in the hospital setting. Hospital acquired infections are infections that patients acquired during the stay in the hospital. These infections can cause an increase in the number of days the patients stay in the hospital. Hospital acquired infections make the patients worse or even cause death. “In the USA alone, hospital acquired infections cause about 1.7 million infections and 99,000 deaths per year”(secondary).
...d procedures are now being monitored to improve clinical processes. Ensuring that these processes are implemented in a timely, effective manner can also improve the quality of care given to patients. Management of the processes ensures accountability of the effectiveness of care, which, as mentioned earlier, improves outcomes. Lastly, providing reimbursements based on the quality of care and not the quantity also decreases the “wasting” and overuse of supplies. Providers previously felt the need to do more than necessary to meet a certain quota based on a quantity of supplies or other interventions used. Changing this goal can significantly decrease the cost of care due to using on the supplies necessary to provide effective, high-quality care. I look forward to this implementation of change and hope to see others encouraging an increase in high-quality healthcare.
difficile acts as a gang when there are few bacteria to check them and can cause diarrhea of the watery variety. A method delivered to calibrate the gut called fecal microbiota transplant utilizing fecal matter containing the essential members of the microbiome community to repopulate the barren, dysfunctional land to create a new one retaining order lost. The utilization of fecal microbiota transplant is a worthwhile option upon the inability of first line drugs such as oral vancomycin or metronidazole to work or in pervasive C. difficile infection running ragged in the microbiome, making the patient sick. I believe this is so due to the empirical studies previously done on the intervention and the success associated. In a study done by Kelly et