Evolution of an audit and monitoring tool into an Infection prevention and control process

Background
In 2010, an Infection Prevention and Control Team in an acute Trust integrated an audit and monitoring tool (AMT) into their management regime for patients with Clostridium difficile infections (CDI). This approach evolved into a daily review process (DRP) that became an essential aspect of the management of all patients with CDI.

Aim
To examine the mechanisms through which the implementation of an AMT impacted on the care and management of patients with CDI.

Methods
A constructivist grounded theory approach was used employing semi-structured interviews with ward staff (n=8), IPCPs (n=7) and matrons (n=8) and subsequently a theoretical sample of senior managers (n=4). All interviews were transcribed verbatim and analysed using a constant comparison approach until explanatory categories emerged.

Findings
All participants recognised that the DRP had positively impacted on the care received by patients with CDI. Two main explanatory themes emerged which offered a framework for understanding the impact of the DRP on care management; firstly education and learning and secondly the development and maintenance of relationships.

Conclusion
The use of auditing and monitoring tools as part of a daily review process can enable ward staff, matrons and IPCPs to improve patient outcomes and achieve the required levels of environmental hygiene because they act as a focal point for interaction, education and collaboration. The findings offer insights into the behavioural changes and improved patient outcomes that ensue from the implementation of a DRP.