OVERVIEW
This free activity, entitled “Strategies to Prevent Clostridium difficile Infections in Acute Care Hospitals: An Expert Interview with Dr. Erik R. Dubberke on Practice Recommendations from SHEA/IDSA,” consists of an audio interview, a Learning Assessment, and an Evaluation form.

MEDIUM: Audio Activity
INTERNET RELEASE DATE: December 10, 2008
CE AVAILABLE UNTIL: December 10, 2009

Estimated time to complete this activity: 40 minutes
(Continuing education credit is no longer available for this activity.)

TARGET AUDIENCE
This activity is designed to meet the educational needs of physicians and registered nurses involved in the management of patients with Clostridium difficile infection in the acute care setting.

ACTIVITY PURPOSE
This activity is intended to assist healthcare professionals in understanding how to manage Clostridium difficile infection (CDI).

STATEMENT OF NEED
Clostridium difficile infection (CDI) is a serious gastrointestinal condition that can cause pseudomembranous colitis, toxic megacolon, and death.1 CDI is becoming an increasing burden to the heathcare system, as rates of CDI in US hospitals have tripled in recent years.2 Recent research suggests that US surveillance of CDI is poor, and many facilities do not adhere to optimal infection control practices.3 Failure to accurately identify and manage outbreaks of CDI can lead to more widespread infection, associated costs, and mortality.

In order to assist acute care hospitals in implementing and prioritizing their CDI prevention efforts, the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA) have recently set forth practice recommendations. The recommendations, titled “Strategies to Prevent Clostridium difficile Infections in Acute Care Hospitals,” are the subject of this interview with author and infectious diseases expert Erik D. Dubberke, MD.

¹ Gerding DN, et al. Infect Control Hosp Epidemiol. 1995;16:459-477.
² McDonald LC, et al. Emerg Infect Dis. 2006;12:409-415.
³ McDonald LC, et al. Infect Control Hosp Epidemiol. 2007;28:140-145.

EDUCATIONAL OBJECTIVES
After completing this activity, the participant should be better able to:

• Explain the rationale for the recommendations set forth by the Society for Healthcare Epidemiology of America (SHEA) and Infectious Diseases Society of America (IDSA) for the prevention of C. difficile infections in acute care hospitals
• Identify strategies to detect and prevent C. difficile infections in the acute care setting
• Outline recommendations for implementing prevention and monitoring strategies
• Cite performance measures that are vital to hospital quality improvement efforts in reducing the burden of C. difficile infections

METHOD OF PARTICIPATION
There are no fees for participating and receiving CE credit for this activity. During the period December 10, 2008, through December 10, 2009, participants must 1) read the learning objectives and faculty disclosures; 2) study the educational activity; 3) complete the Learning Assessment by recording the best answer to each question in the “Learning Assessment Answers” box on the Evaluation form; 4) complete the Evaluation form; and 5) mail or fax the Evaluation form with the Learning Assessment answers to Postgraduate Institute for Medicine. You may also complete the Learning Assessment online at www.cmeuniversity.com. Click on “Find Post-Test/Evaluation by Course” on the navigation menu, and search by project ID 6057.

Participants must receive a score of at least 70% on the Learning Assessment and must complete and submit the Evaluation form to successfully complete this activity. Participants who successfully complete the Learning Assessment and Evaluation form via www.cmeuniversity.com will have a statement of credit made available immediately. Participants who successfully complete this activity and submit the Learning Assessment and Evaluation form via fax or mail will be issued a statement of credit via US mail in 4 to 6 weeks.

PHYSICIAN CONTINUING EDUCATION

ACCREDITATION STATEMENT
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Postgraduate Institute for Medicine (PIM) and Robert Michael Educational Institute LLC (RMEI). PIM is accredited by the ACCME to provide continuing medical education for physicians.

CREDIT DESIGNATION
PIM designates this educational activity for a maximum of 0.5 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

INTERNATIONAL PHYSICIANS
International physicians completing this activity will receive a certificate documenting participating in an activity designated for 0.5 AMA PRA Category 1 Credit™.

International physicians should contact their respective licensure and certification bodies for information on use/conversation of AMA PRA Category 1 Credit(s)™.

NURSING CONTINUING EDUCATION

CNA/ANCC
This educational activity for 0.6 contact hour is provided by PIM.

Postgraduate Institute for Medicine (PIM) is an approved provider of continuing nursing education by the Colorado Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

A statement of credit will be issued only upon receipt of a completed post-test and activity Evaluation form.

FACULTY
Erik R. Dubberke, MD
Assistant Professor of Medicine
Infectious Diseases Division, Department of Medicine
Washington University School of Medicine
Medical Director, Infection Control
Missouri Baptist Medical Center
St. Louis, Missouri

DISCLAIMER
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information and comparison with recommendations of other authorities.

DISCLOSURE OF UNLABELED USE
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Postgraduate Institute for Medicine (PIM), Robert Michael Educational Institute LLC (RMEI) and ViroPharma Incorporated do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of PIM, RMEI, or ViroPharma Incorporated. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings.

DISCLOSURE OF CONFLICTS OF INTEREST
Postgraduate Institute for Medicine (PIM) assesses conflict of interest with its instructors, planners, managers and other individuals who are in a position to control the content of continuing education (CE) activities. All relevant conflicts of interest that are identified are thoroughly vetted by PIM for fair balance, scientific objectivity of studies utilized in this activity, and patient care recommendations. PIM is committed to providing its learners with high-quality CE activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CE activity:

• Erik R. Dubberke, MD, has an affiliation with Genzyme Corporation, Merck & Co., Inc., and Salix Pharmaceuticals, Inc. (Consultant).

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CE activity:

Robert Michael Educational Institute LLC

• Sherri Kramer, MD, has no affiliations with commercial interests to disclose.
• Elise Paxson has no affiliations with commercial interests to disclose.
• Laura Altobelli, MS, has no affiliations with commercial interests to disclose.

Postgraduate Institute for Medicine

• Jan Hixon, RN, BSN, MA, has no affiliations with commercial interests to disclose.
• Linda Graham, RN, has no affiliations with commercial interests to disclose.
• Trace Hutchison, PharmD, has no affiliations with commercial interests to disclose.

FEE INFORMATION
There is no fee for this educational activity.

QUESTIONS & TECHNICAL ASSISTANCE
For questions regarding the content of this activity, contact the accredited provider for this CE activity: jjones@pimed.com. For technical assistance, contact jungsen@rmcom.net.

SYSTEM REQUIREMENTS
Hardware/Software requirements include:
• Windows 95, 98se, ME, XP, NT 4.0, 2000   
  - Internet Explorer 4.0+
  - Netscape Navigator 6.2+
  - AOL 8
  - Mozilla Firefox 1.0+
• Macintosh 9.2, OS X 10.1+
  - Safari 1.1+
  - Netscape Navigator 6.2+
  - Internet Explorer 5.2+
  - Mozilla Firefox 1.0+
• Additional Requirements
  - Macromedia Flash Player 7
  - Internal/external speakers
  - Broadband connection (DSL/cable) recommended

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visit www.RMEI.com.

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