Smith, Lisa AnnLisa AnnSmithDr. CHAN Chi Keung, AlexAlexDr. CHAN Chi KeungHalm, MargoMargoHalmSlattery, WendolynWendolynSlatteryLindquist, RuthRuthLindquistSavik, KayKaySavik2018-07-062018-07-062014AACN Advanced Critical Care, Oct-Dec 2014, vol. 25(4), pp. 334-346.1559-77681559-7776http://hdl.handle.net/20.500.11861/5267The incidence of Clostridium difficile infection has increased rapidly during the past decade, increasing lengths of stays in the hospital, costs, and mortality rates. To address this increased incidence, we performed a retrospective case-control study using known risk factors to develop a tool to determine which patients are at risk for infection. Multivariate analysis generated a combination of risk factors associated with development of infection including prior admission, endoscopy within 30 days, cephalosporin/fluoroquinolone use, length of stay 7 days or longer, age 65 years or older, body mass index less than 25, and albumin level less than 2.7 g/dL. A weighted scoring tool was created that predicted disease with a sensitivity of 86% and a specificity of 44% in the derivation sample, and 92% sensitivity and a specificity of 39% when applied to the validation sample. Application of this 8-item tool by nurses in multiple settings could aid in the determination of patients who are at risk, allowing prophylactic treatment, prompt isolation of patients, restricted antibiotic use, and decreased testing of low-risk patients.enPeer Reviewed Journal Article10.1097/NCI.000000000000004625334