761: Stop the Spread: Reducing Hospital-Acquired C Difficile Infections in a Community Icu

Introduction: Hospital-acquired Clostridioides difficile infections (HA-CDI) are a leading cause of healthcare-associated diarrhea, contributing to patient morbidity, prolonged stays, and higher healthcare costs. In 2024, our 436-bed community hospital surpassed the NHSN benchmark of 6.3 cases per 10,000 patient-days. A multidisciplinary QI team was launched to identify modifiable risk factors and implement targeted, evidence-based strategies to reduce HA-CDI, with institutional priority placed on ICU rates. Methods: Using the Plan-Do-Study-Act model, a year-long QI project began in January 2025. Team members included physicians, residents, pharmacists, infection preventionists, nursing leadership, EVS, clinical educators, and executive leadership. Interventions included: - Environmental cleaning enhancements with sporadical agents, UV disinfection, and monthly random surface cultures. - Hand hygiene auditing with real-time feedback, unit-level dashboards, and a comprehensive hospital-wide advertising campaign supported by the C-suite, including follow-up messaging from leadership to reinforce staff engagement. - Antibiotic stewardship via daily pharmacy-led review of high-risk antibiotics and prescriber feedback. - Contact precaution reinforcement with PPE reorganization and quarterly donning/doffing education. Results: Between 2023 and 2024, hospital-wide CDI cases decreased from 27 to 26 (↓3.7%), while ICU cases rose from 4 to 7 (↑75%), prompting a focused ICU initiative. Since initiating interventions in January 2025, no ICU CDI cases have been reported through March 2025. Hand hygiene compliance rose dramatically in late 2024, peaking near 100% in October, with >900 observations that month. Increased observation frequency and executive follow-through were key contributors to sustained improvement. Conclusions: A targeted, multidisciplinary QI initiative involving front-line teams and executive leadership led to early reductions in ICU HA-CDI. Environmental disinfection, stewardship, and hand hygiene which was amplified through C-suite–supported campaign. This drove cultural change. Ongoing monitoring, leadership engagement, and staff reinforcement remain critical for sustaining success and expanding impact.