Nurse-Led Protocol Slashes C. Diff Infections in Nephrology Unit

A nephrology unit at Detroit's Henry Ford Hospital reduced hospital-acquired Clostridioides difficile infections by 90% after implementing nurse-driven protocols. The unit's infection rate fell from 34 per 10,000 patient-days to 3.34 per 10,000 patient-days over a year. A root cause analysis revealed misclassification of community-onset cases and gaps in nursing education and accountability, which the intervention addressed.

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The nephrology unit's initial infection rate of 34 per 10,000 patient-days was roughly nine times the hospital-wide average of 3.8. Investigators discovered that five of eight early cases were actually community-onset infections mislabeled as hospital-acquired due to incomplete documentation, which skewed the risk picture and delayed proper treatment. The corrective plan combined weekly bleach-cleaning