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Reducing Recurrence and Complications Related to Clostridioides difficile: A Panel Discussion

*** 3.5 RN, CCM and CME hours ***
The most common cause of diarrhea occurring in a health care setting is Clostridioides difficile (C. diff) and is also the cause of antibiotic-associated colitis (McDonald, 2021). The infection results from a disruption in the microbial flora of the gastrointestinal tract, mainly after antibiotic use or some other medications such as PPIs. As a result, infected individuals are colonized and shed the spores into the environment, exposing others—goals of treatment focus on reducing the exposure and individual susceptibility.
Although the incidence of C. diff is stable, recurrence is increasing significantly, with severe complications also a concern. The increased incidence and potential for life-threatening conditions require reducing initial exposure, supporting prescribed treatment, and preventing recurrence.

Effective and efficient care transitions and coordination are the solutions to reducing the incidence and adverse events. Case managers need to take a primary role in the transition and care coordination processes, including patient and support system education, coordination of any post-discharge services, connection to providers, adherence support activities, and follow-up for improvement or changes in condition. Supportive adherence activities and prevention education will result in the avoidance of recurrence.

Case managers are well-equipped to locate resources to assist those patients challenged with the cost of medications, inability to attend appointments or access basic needs. While not directly related to C. diff, these challenges contribute to recurrence and readmission. Mitigating risk for readmission and recurrence results in an improved quality of life.

This panel discussion brings together professionals from gastroenterology, epidemiology, long-term care, pharmacy, and case management to share current best practices for reducing risk and emerging technologies that are expected to change how C. diff is managed.

As a result of the program the participant will:

  1. Describe the disease process of C. diff including symptoms and complications
  2. Identify current best practices for treatment and prevention of recurrence
  3. Apply best practices for care transitions for the patient with C. diff to include the post hospital period for prevention of recurrence and readmission
  4. Differentiate the risks in long-term care settings and how best to prevent infection and recurrence
  5. Analyze the latest information about treatment and its potential to change the risk associated with C. diff.
Glenn Tillotson, MSc, PhD, FIDSA, FCCP, Epidemiology
Cheri Lattimer, RN, BSN, Care Transitions
Melanie Prince, MSS, MSN, BSN, NE-BC, CCM, FAAN
Sahil Khanna, MBBS, MS, Gastroenterology
James E Lett, II, MD, CMD-R, Long-term Care
Panel Chair: Rebecca Perez, MSN, RN, CCM