Hospital Onset Diarrhoea Investigation

National Infection Trainees Collaborative for Audit and Research (NITCAR) Service Evaluation: The Prevalence, Aetiology and Management of Hospital-onset Diarrhoea on Medical, Surgical and Elderly Care Wards in the NHS

Status

Completed

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT03321578

Acronym

HOODINI

Enrollment

230

Registered

2017-10-25

Start date

2016-01-31

Completion date

2016-08-31

Last updated

2017-10-25

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Diarrhea

Keywords

nosocomial, hospital acquired, clostridium difficile

Brief summary

This service evaulation aims to investigate how common diarrhoea is in hospital patients on medical, surgical and elderly care wards, what it is due to and how it is managed.

Detailed description

Latest National Health Service (NHS) England guidelines for the assessment of Clostridium difficile infection (CDI) cases recommend that acute hospitals collect data on the prevalence of hospital-onset diarrhoea in their organisations, and how it is managed, including if patients are appropriately tested for CDI. The aims of this multi-centre service evaluation are therefore to: * Determine the prevalence of hospital-onset diarrhoea on adult medical, surgical and care of the elderly wards in the NHS * Investigate how hospital-onset diarrhoea is managed, including whether patients are tested for CDI according to Department of Health (DoH) England standards * Investigate the aetiology of hospital-onset diarrhoea on adult medical, surgical and care of the elderly wards in the NHS, based on previously described causes Data will be collected at participating centres on two days, one between 11-15/Jan/2016 and one between 6-10/Jun/2016. Hospitals will be able to choose locally which two days. On those days investigators from the local Microbiology and/or Infection Prevention teams will screen all patients on pre-identified wards, who have been admitted for ≥72 hours, for hospital-onset diarrhoea. For all patients that meet the definition of hospital-onset diarrhoea their medical notes and charts will be reviewed, to ascertain potential causes and how they have been managed. This service evaluation should help participating hospitals to investigate hospital-onset diarrhoea in their own institutions, as well as generating a dataset that is representative of the problem across the NHS, and therefore of use to other centres.

Interventions

None listed

Study design

Observational model

CASE_ONLY

Time perspective

CROSS_SECTIONAL

Eligibility

Sex/Gender

ALL

Age

16 Years to No maximum

Healthy volunteers

Inclusion criteria

* Admitted to hospital for ≥72 hours at the time of data collection for the service evaluation * Presence of hospital-onset diarrhoea (defined as ≥ 2 episodes of unformed stools (Bristol Stool Chart type 5-7) during the day before the service evaluation, with the onset of the diarrhoea being more than 48 hours after admission to hospital)

Exclusion criteria

* Patients admitted to the ward for ≤72hour at the time of data collection for the service evaluation * Patients with diarrhoea since admission or in whom it developed within the first 48 hours of admission * Patients receiving end of life care

Design outcomes

Primary

Measure	Time frame
Point-prevalence of hospital-onset diarrhoea	At enrollment

Secondary

Measure	Time frame
• The proportion of patients with hospital-onset diarrhoea who have been assessed for the problem by a member of the clinical team.	At enrollment
• The proportion of patients with hospital-onset diarrhoea that are tested for CDI (both overall and amongst those who do and do not have an alternative explanation for the diarrhoea).	Up to 72 hours after enrollment

Countries

United Kingdom

Outcome results