A qualitative study on factors influencing the implementation of a Clostridium difficile risk prediction tool in the Scottish secondary care setting

Introduction: Clostridium difficile is the leading cause of hospital acquired diarrhoea, driven by the consumption of 4C antibiotics (co-amoxiclav, clindamycin etc..). In order to support clinicians with the prescription of antibiotic in secondary care, an algorithm to help identify high risk patients to contract Clostridium difficile infection (CDI) has been created. The aim of this study is to identify factors that are influencing the development and implementation of a risk predictive tool for CDI in secondary care.

Methods: Four Scottish Podiatrist from Fife were interviewed to gather their perception on CDI, their antibiotic prescription process and whether a CDI tool would support their prescription process. The interviews were inductively analysed in NVivo using the consolidated framework for implementation research to identify factors influencing the development and implementation of the CDI tool.

Result: The preliminary interview themes suggests that although Podiatrist in secondary care don’t perceive many cases of CDI, they would like to have risk predictor for CDI for patient’s safety netting purposes. As there isn’t a concrete and accurate electronic health record in secondary care, the CDI tool can’t be implemented into their system, therefore a standalone app or website has to be developed.

Conclusion: The next stage is to collaborate with a company to develop a prototype of the CDI tool and test it with secondary care clinicians using case scenarios.