Safety Teams and Organizational Structure
    Access to Information
    Facility Expectations
    Engagement of Patient/Client/Resident and Family





Key Items

Road Map to a Comprehensive Healthcare-Associated Infections (HAI) Prevention Program. Complete the HAI road map prior to beginning the gap analysis.

Clostridium difficile Infection (CDI) Prevention Strategies - Gap Analysis. Complete this gap analysis to identify where you need to develop action plans.

Clostridium difficile (CDI) - a priority healthcare-associated infection

CDI Gap Analysis

The Clostridium difficile Infection (CDI) Prevention Strategies - Gap Analysis includes a checklist of core and enhanced prevention strategies. Core prevention strategies should always be in place. Examples include:

  • Provide patient/family education.
  • Ongoing CDI surveillance.
  • Early identification of patients with suspect CDI.
  • Isolation precautions
  • Clean and disinfect patient rooms and patient care equipment.
  • Implement an antimicrobial stewardship program.
  • Documentation practices.





Share Your Knowledge/Contribute to this Site

You'll notice that some sections of this website lack supporting materials. We're asking CHAIN participants to share tools and resources to add to this site. Sharing knowledge will help us all provide better care to people in Minnesota.

Send us your tool and resource suggestions.

Be an active member of CHAIN. Together, we can reduce HAI rates.

Enhanced prevention strategies should be considered in addition to core strategies when there is evidence of:

  • Core strategies not being implemented and adhered to consistently
  • Ongoing transmission of CDI
  • CDI rates not decreasing
  • Change in CDI pathogenesis (e.g., increased morbidity/mortality among CDI patients)


Tools for CDI Road Map Topics - Supporting CDI Reduction   

Use these sample tools as templates and to take action in your organization.

Patient and Family Education


Insertion - Insertion practices

Maintenance - Maintenance practices

Removal - Removal practices

Documentation - Documentation practices

General Resources

Sample Tools - Apply/Take Action

Clostridium difficile Infections (CDI) Toolkit. A health care provider’s guide to preventing clostridium difficile infections, developed by the Oklahoma Foundation for Medical Quality and Stratis Health. This toolkit is a compilation of evidence-based research and guidelines, recommendations, tools, and resources to be used in work on CDI prevention. (26-page Word doc)

Controlling CDI: A Two-Pronged Approach to CDI Prevention. The Minnesota Hospital Association, funded by CMS’s Leading Edge Advanced Practice Topics, has compiled two Controlling CDI tool kits: Controlling CDI Hand Hygiene and Controlling CDI Environmental Cleaning Training and Supervision.

Toolkit for Reduction of Clostridium difficile Infections Through Antimicrobial Stewardship: The Evaluation and Research on Antimicrobial Stewardship's Effect on Clostridium difficile (ERASE C. difficile) Project. This toolkit assists hospital staff and leadership in developing an effective antimicrobial stewardship program with the potential to reduce C. difficile. An antimicrobial stewardship program is a systematic approach to developing coordinated interventions to reduce overuse and inappropriate selection of antibiotics, and to achieve optimal outcomes for patients in cost-efficient ways.

Professional Education and Training

Accelerating Prevention of Clostridium difficile infection. In 2014, Approximately 83,000 of the patients who developed C. difficile experienced at least one recurrence and 29,000 died within 30 days of the initial diagnosis. This webinar discusses targeting and implementing CDI prevention strategies in the acute care settind. (55-minute video)


C. difficile Prevention: A Multi-Faceted Approach. This webinar, presented on September 17, 2013, by Susan Kellie MD, MPH, hosted by the Great 8+ QIO Group, illustrates how to:

  • Identify recent changes in the epidemiology of C. difficile Infection (CDI) including transmission and risk populations
  • Describe evidence based best practices involved in a multi-faceted approach to prevention of CDI
  • Recognize the problem areas in CDI prevention and discuss possible solutions


IDSA Clinical Practice Guideline - Clostridium difficile. This guideline is designed to improve the diagnosis and management of Clostridium difficile infection (CDI) in adult patients. A case of CDI is defined by the presence of symptoms (usually diarrhea) and either a stool test positive for C. difficile toxins or toxigenic C. difficile, or colonoscopic or histopathologic findings revealing pseudomembranous colitis. In addition to diagnosis and management, recommended methods of infection control and environmental management of the pathogen are presented. The recommendations are based on the best available evidence and practices, as determined by a joint Expert Panel appointed by SHEA and the Infectious Diseases Society of America (IDSA) (the SHEA-IDSA Expert Panel). Published in Infection Control and Hospital Epidemiology 2010; 31 : 431-455 "Clinical Practice Guidelines for Clostridium difficile Infection in Adults: 2010 Update by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA)"

Strategies to Prevent Clostridium difficile Infections in Acute Care Hospitals. Compendium of infection prevention recommendations for acute care hospitals by the Society for Healthcare Epidemiology of America/Infectious Diseases Society of America (SHEA/IDSA). Published in Infection Control and Hospital Epidemiology 2008 Oct;29 Suppl 1:S81-92.

Patient Education

CDI: Clostridium difficile Infection Patient Education. Patient brochure with frequently asked questions and answers from the Infection Control Professionals of Southern New England. (2-page PDF)

Frequently Asked Questions (FAQs) about CDI. Questions and answers CDI fact sheet from a coalition of national infection prevention organizations. (1-page PDF)

FAQs about CDI (Spanish). Questions and answers CDI fact sheet in Spanish from a coalition of national infection prevention organizations. (1-page PDF)

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CHAIN is an effort lead by the Association for Professionals in Infection Control and Epidemiology-Minnesota (APIC MN), Minnesota Department of Health, Minnesota Hospital Association, and Stratis Health, which represents Lake Superior Quality Innovation Network in Minnesota.