Electronic Order Entry to Reduce Unnecessary PCR Screening for Clostridium difficile Infection

With use of enzyme immunoassay or other early-generation screening tools with low sensitivity for diagnosing Clostridium difficile infection (CDI), the practice of repeat testing crept into patient management. Later-generation assays such as polymerase chain reaction (PCR), which are characterized by increased sensitivity, are now in place, but repeat screening ≤7 days after an initial negative test is still being done. In a recent retrospective cohort study, investigators evaluated the effect of hospital information system alerts in reducing unnecessary repeat PCR testing for CDI.

The Stanford Medical Center established a policy for rejecting repeat PCR screening for CDI within 7 days of an initial test, except with approval by the laborato…