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Implementation of a Decision Tree to Optimize Clostridium difficile Testing

      BACKGROUND: Significantly higher Clostridium difficile (C. difficile) testing rates were noted at our facility as compared to similar sized hospitals within our healthcare system. Investigation revealed inappropriate testing was occasionally being conducted. Studies have reported 36-50% of hospitalized patients tested for C. difficile do not have clinically significant diarrhea, and 20-44% of patients tested are on laxatives. Inappropriate testing leads to inaccurate hospital-onset (HO) rates, increased costs related to testing, unnecessary isolations, and antibiotic overuse. The objective of this study was to decrease the number of inappropriate specimens sent for C. difficile testing at our facility.
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