1. Ohio Hospital Association Learning from Patient Stories
June 15, 2017

2. The Stakes…

3. Who Was Peggy?

4. Peggy’s C. diff Story Broad spectrum antibiotic following root canal
Symptoms begin 5 days into course
Suspected stomach virus
Admitted to hospital 5 days after diarrhea onset
Died 36 hours later

5. Lessons from Peggy’s Story
Lack of C. diff Awareness
Persistence of C. diff Myths
Antibiotic Overuse (Prophylaxis)
No warning from dentist
Danger of Prescribing Imodium

6. Learning from Patient Stories
With C. diff changing, patient experiences:
Humanizes statistics
Breaks through C. diff mythology
Illustrates challenges and opportunities in infection control, prevention, public education, transparency and treatments
Highlights opportunities for collaboration

7. Apryl Gleespen Healthy 59 year-old from Akron with recurrent UTIs
Given 3 different antibiotics in a 2-month span
Failed Flagyl and Vanco, surgery was suggested
Saved by fecal transplant via nasal-gastric tube
Lessons
Polypharmacy can occur with antibiotics
Current treatments remain insufficient for some patients

8. Andi L. 4 year-old from Zanesville started with vomiting and diarrhea
No recent antibiotics usage
Pediatrician initially dismissed C. diff due to age
Multiple courses of flagyl eventually resolved infection
Lessons
Every year, 17,000 children get C. diff infections in the US
CDI can occur without recent antibiotic usage

9. MaryAnn Dillon ER Nurse for 25 years Atypical C. diff presentation
Worked with Peggy’s sister
Peggy’s story was impetus for MaryAnn to request C. diff test
C. diff cost her 3 months of work
Lessons
Healthcare Workers are at risk
Personal stories resonate

10. PLF’s Work Awareness Raising & Education Advocate Training
C. diff Stories
PSA, Website and Social Media
Hospitals, QIOs, Agencies
Advocate Training
Amplifying Our Work Locally
HAI Committees, Hospitals, Media
Policy Advocacy
Increased Funding for ARO
Increased Surveillance/Reporting

11. Moving Past Blame… Cycle of Blame Doctors Administration Nurses
Janitorial
Patients
Cycle of Blame

12. C. diff is changing 1 patient with C. diff dies every 5 minutes
5 patients are diagnosed with C. diff every minute
Infections rates have doubled since 2001
10% of patients colonized at admission
50% of cases are community-acquired
Strains increasingly virulent and deadly
Previously, low-risk populations (post-partum women, children, etc.) are getting C. diff
CDC now classifies C. diff as an “urgent threat”

13. 29,000 deaths according to CDC
Tip of the Iceberg
29,000 deaths according to CDC
109,000 deaths
2008 Prevalence Study
Nursing Home Deaths
(Unreported)
Community Deaths

14. We have the knowledge & technology…
We know how to minimize transmission in hospitals
High degree of hand washing and sanitation compliance
Vigorous environmental cleaning coordinated with Infection Control
Active detection and isolation of suspected carriers
Antibiotic stewardship
Education of patients and visitors
New technologies from more sensitive tests to UV cleaning technologies are emerging regularly
Too often the missing ingredient is the will to change

15. All Hands on Deck!
C. diff is a complicated public health issue with several direct and indirect causes
It requires nuanced, manifold approaches
Intra-hospital and inter-facility
Public awareness
Treatment and prevention development
We all have a role to play

16. Working Together Doctors, Nurses & other Healthcare Workers
Patients & Advocates
Healthcare Administrators
Policymakers
Clostridium difficile

17. “All you have in this world is each other.”

18. A World Where C. diff is Rare, Treatable & Survivable.
Peggy’s Vision
A World Where C. diff is Rare, Treatable & Survivable.