Researchers Find Inpatients Were Most Likely to Acquire a C.diff. Infection When Census Was Between 25-75% Capacity

In a study of more than 550,000 patient discharges from 327 California hospitals, researchers found that patients were most likely to contract Clostridium difficile (C.diff., CDI, C.difficile) —a stubborn and potentially deadly hospital-associated infection (HAI) —when inpatient wards were in the “middle range” of capacity, or between 25% and 75% full.

“Our hypothesis going in was essentially that when hospitals are busier, perhaps care quality is compromised,” Mahshid Abir, M.D., assistant professor of emergency medicine at UM Medical School and the study’s lead author, told FierceHealthcare. “Certainly when we saw these findings, we were surprised.”

Overall, more than 2,000 patients included in the study, which looked at discharges between 2008 and 2012, contracted C. diff during their hospital stay. Hospitals often struggle to control C. diff infections, and a significant number of readmissions can be linked to such infections.

By basing the study around a model that accounts for seasonal staffing changes or unit closure, for example, researchers were better able to filter out infections that a patient had before arriving at the hospital, she said. Calculating occupancy in this way could also help providers identify potential risk factor for infection, according to the study.

Patients admitted to a unit that was at between 25% and 75% capacity were three times more likely to contract C. diff compared to those in units at below 25% or above 75% capacity, according to the study.

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