Fig. 1.

Timeline of Clostridioides difficile infection (CDI) Targeted Assessment for Prevention (TAP) Strategy implementation and related prevention activities in participating facilities, healthcare system TAP Strategy implementation for CDI prevention.

^aTo address early detection and isolation of CDI patients and C. difficile testing practices, the healthcare system provided education to nurses and physicians regarding appropriate testing practices, implemented a CDI testing algorithm for nurses to guide appropriate specimen collection and implementation of contact precautions, and established a C. difficile testing audit tool for laboratory personnel to confirm specimen was appropriate for testing or rejection.

^bThe healthcare system reported updating their electronic medical records to include a criteria-for-use C. difficile order form, requiring ordering providers to confirm appropriate criteria were met prior to the test order.

^cThe healthcare system provided an in-person, infectious disease physician–led continuing medical education (CME) course for physicians focusing on CDI prevention, including appropriate testing practices and antibiotic stewardship.

^dThe healthcare system reported updating their CDI testing policy to include an order cancellation for specimens not collected within 24 hours.

^eThe healthcare system reported implementing an electronic criteria-for-use order form for fluoroquinolones. This order form required prescribers to select an appropriate reason for ordering the respective antibiotics, and initiated an auditing process if an order was placed in the absence of an appropriate selection.