1. Root Cause Analysis Tool- extended version

A Root Cause Analysis (RCA) tool to help your hospital team understand the factors impacting your hospital’s C. difficile rates by assessing diagnostic practices, environmental cleaning practices, antibiotic prescribing, and patient risk factors for each C. difficile case.

2. Root Cause Analysis Tool- short version

A shorter version of the Root Cause Analysis (RCA) tool (#1 under General Tools) to help your hospital team understand and assess the factors impacting your hospital's C. difficile rates, including diagnostic practices, environmental cleaning, patient risk factors, and antibiotic prescribing.

1. Diarrhea Algorithm

A one page algorithm that helps providers determine whether patients with symptoms of C. difficile (primarily diarrhea) require C. difficile testing and/or isolation based on factors including laxative use and prior C. difficile testing .

2. Information about NHSN risk adjustment processes

The negative binomial regression model that NHSN uses to calculate the "predicted" number of infections for the C. difficile. LabID events CAD and SIR calculations are included on page 8 of this Guide.

3. C. diff One Minute Guide- Step by Step

A concise guide for reducing unnecessary C. diff testing and the potential benefits of reducing over-testing. States that it is NOT appropriate to test to test patients for C. diff in the following situations: a) patient had < 3 unformed stools in the past day; b) Patient received laxatives in the past 48 hours; c) Retesting C. diff positive patients within 7 days; and d) testing C. diff positive patients to confirm they are cured.

Links coming soon

1. Instructions for ATP-based monitoring program

CDC resources for ATP/ environmental cleaning.

2. Hygiena Resources

This link provides a list of resources from Hygiena, the company that makes ATP testing devices used around the globe.

3. pH Pen protocol for monitoring use of bleach

A concise instruction guide for using pH pens to determine if the correct disinfectant was used when cleaning a C. difficile room. Provides general instructions as well as more detailed steps. Also includes a color chart for interpreting the markings left by a pH pen.

4. Protocol for Assessment of Environmental Cleanliness using ATP Testing

This is a tool to guide ATP surface testing.

1. AHRQ Safety Program web page

Introduces the AHRQ Safety Program for Improving Antibiotic Use.

2. SIDP pharmacist training course

A link to register for the SIDP Antimicrobial Stewardship Certificate Program for Pharmacists, which consists of practice-based activities designed to teach pharmacists about the appropriate use of antimicrobial agents. This page includes information on the goals and structure of the program, the cost of the program, and instructions on how to complete the program.

3. Johns Hopkins stewardship guidelines

A link to review guidelines for antibiotic use from the Johns Hopkins Department of Antimicrobial Stewardship.

4. Rapid Diagnostic Test

This tool, developed by Kim Claeys, explains how to use results of rapid diagnostic tests to guide antimicrobial use.

1. Observation Tool: Shared Equipment Disinfection Assessment

This tool is aimed to improve the protocol for disinfection of shared equiment used for isolated patients.

2. Observation Tool: Hand Hygiene and PPE Audit Tool

The is a tool to assist in the audit of proper PPE usage.