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Big change from small measures

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Introducing a range of small, practical improvements to elderly care wards can significantly reduce Clostridium difficile rates, data suggests.

Putting stickers on commodes after cleaning, so staff can see which ones are dirty, and introducing a movement-activated voice box reminding people to wash their hands have seen infection rates plummet at a Manchester trust.

Salford Royal NHS Foundation Trust had over 400 recorded cases of the infection in 2006–2007, 30% of which came from five elderly care wards alone, conference delegates heard last week.

With the aim of reducing this figure by 50% in 12 months, a multidisciplinary team – including nurses, pharmacists and domestic staff from each of the five wards – met to ‘brainstorm’ ideas for improving infection control practices, which were then taken back to wards to see how they worked in practice.

Since the initiative began, there has been a 68% reduction in the rates of C. difficile on the five wards – from 122 recorded cases in April 2007 to just 38 cases in April 2008.

Maxine Power, associate director of quality improvement at the trust, said: ‘This shows that adopting different ways of thinking, and making small, practical changes that are robust and reliable, can have a significant impact on infection rates.’

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