(精选)梭状芽孢杆菌(英文课件)Clostridium difficile - a new Disease教学课件.ppt

RWHT Response Also major problems with MRSA bacteraemias RWHT Response DoH MRSA HCAI Improvement Programme Disband ICC Form IPB: chaired by Chief Executive performance management for Divisions and Wards RWHT Response to C. difficile Regular commode auditing Replacement of 100 old/damaged commodes Replacement of 300 mattresses Introduction of ‘Saving Lives’ HII Number 6 following every case of CDAD Root cause analysis on every case Introduction of hotel style bed space check lists following discharge of every patient RWHT Response to C. difficile Matron led ward de-clutter programme Introduction of monthly clutter collection 200 domestics trained in CDAD and the role of the environment Medical division nurse training on CDAD, spread and role of equipment Grand Round presentation of case studies and action on CDAD. Mandatory attendance of at least one member of every clinical team. 250 attended RWHT Response to C. difficile ‘Slide card’ for infection prevention for all staff C. difficile management / treatment guidelines New antimicrobial guidelines Antimicrobial prescribing policy Monitoring and antimicrobial prescribing performance management of Divisions Ward refurbishment programme C. difficile – Antibiotic Risk High Risk Antibiotics: Cefotaxime Ceftriaxone Cefalexin Cefuroxime Ceftazidime Ciprofloxacin Moxifloxacin Clindamycin (low dose) Medium Risk Antibiotics: Meropenem Ertapenem Clindamycin (high dose) Co-amoxiclav Tazocin Erythromycin Clarithromycin C. difficile – Antibiotic Risk Low Risk Antibiotics: Benzyl penicillin Gentamicin Amoxicillin Metronidazole Flucloxacillin Vancomycin Tetracyclines Teicoplanin Trimethoprim Synercid Nitrofurantoin Linezolid Fusidic acid Tigecycline Rifampicin Daptomycin Symptomatic Proven or Suspected C. diff infection Assess Patient: AXR, CRP, U E’s, FBC Stool Chart Stool for C. diff culture (if not done) Consider Flexi Sig if diagnosis in doubt Review Antibiotics Treatment Algorithm For New Cases of C. diff