What's New

An Important Clostridium Difficile (C. diff) Update

The strain of C. diff present in recent years in the U.S. in at least 40 percent of C. difficile patients is a far more severe and even lethal one than seen previously. C. diff is responsible for as many as 29,000 deaths a year according to the CDC. November is C. difficile Awareness Month and a network performance improvement group in infection prevention recently embarked upon a 12-month education and communication campaign to reduce patient experience of C. diff.

Algorithms for testing were developed and can be reviewed here. The intent of these algorithms is the same: identify community acquired C. difficile in the first three days of hospitalization and prevent unnecessary testing and patient harm. A stool positive for C. diff in the first three days of hospitalization is community acquired and this is an important distinction. Do not re-test for C. diff during the same episode once C. diff is positive and do not do multiple tests once C. difficile is positive. Do not “test for cure” or re-test to remove a patient from isolation. C. diff and its toxins may persist in stool after the resolution of symptoms and is of uncertain clinical significance. “Clinically significant diarrhea” is defined at three or more episodes of loose, watery stool within a 24-hour period with an unknown cause, but may also be a shorter diarrheal period in a patient with unexplained leukocytosis or fever.

Enhanced Contact Precautions are required for these patients with use of a gown and glove upon entry to the room. Each room should be equipped with a stethoscope for clinician use. Every attempt should be made not to bring anything into the room. All items taken in and brought out of the room must be fully wiped down with bleach (orange top) wipes before exiting. Handwashing is done thoroughly with soap and water as alcohol hand sanitizers are not effective against the spores of C. diff. Patients must have formed stool for 24 hours to discontinue precautions.

Please watch for ongoing updates on this topic, and help us help our patients reduce C. difficile and its devastating impact.

Diagnostic Imaging: Critical Results and Significant Findings

The Imaging Departments at Jersey Shore, Ocean, Riverview, Southern Ocean, and Bayshore are now utilizing the Powerscribe 360 Voice Recognition System allowing finalized reports to be available quicker. The system has the ability to track the delivery of Critical Results and Significant Findings.

Critical Results will still require direct communication from the radiologist to the ordering physician or direct care giver. However, our hospitals will now be utilizing the dictation system to relay Significant Findings. The Joint Commission and American College of Radiologists are now mandating that all Imaging Departments have a method of documentation of communication of these results to ensure that clinically significant information does not “fall through the cracks.”

The dictation system will allow the communication of Significant Findings to you by fax, a text message to your phone, or an email. The choice is yours.

Here’s how it all works:

  • If we send a fax to your office, someone from your staff needs to call a phone number to acknowledge receipt of the fax and results.
  • If we send you a secure text, you can click on a link within the text that takes you to the voice version of the report, and automatically indicates to the system that the result was picked up.
  • Lastly, and probably most simple, is to set up an email account for your office through Yahoo, Gmail, or any other free email service. We would then email that account with a notification and a link. Clicking the link will take you or your office staff directly to the result, and automatically acknowledges receipt.

Enhanced communication of Significant Findings will be implemented soon. The communication method is your choice. Please make sure you have selected your preferred method of communication, or your office will default to a fax to your office. Once you have decided on the communication selection for your practice, please contact your local hospital’s Imaging Department.


  • New App for Clinical Support Available

    UpToDate clinical decision support is a trusted resource that is proven to improve outcomes for health care organizations. Meridian Health providers now have access to this powerful evidence-based content at the office, at home, or at a patient’s bedside. With an increased focus on improving quality and safety of care while lowering cost, the use of UpToDate has been associated with decrease length of stay in hospitals and lower mortality rates. Even better, if you register and sign in every time you do a search, you earn 0.5 AMA Category 1 CME credits for each question researched.

    To register for UptoDate:

    • Log on to Dashboard
    • Select the UptoDate link found in Helpful Links on the left side of Dashboard
    • First time in, select Login / Register and complete the registration process

    Note: You cannot use your Meridian username and password for registration

    • Once registered, the system will immediately recognize you and track your CME credits.

    UptoDate also offers a smartphone “app”; this application can be used to access UptoDate on your smartphone.  

    • On your smartphone or tablet, search for “UpToDate” in your app store and install the free app

    • Open the UpToDate Mobile App upon completion of download

    • Log in with your UpToDate User Name and Password. You only need to do this once – the app remembers your User Name and Password

    Note: You will be required to login to UptoDate on Meridian Dashboard at least once every 30 days to confirm ongoing participation in the Meridian program.

    The UpToDate Anywhere: Reference Guide is available in the physicians’ lounge in all 5 Meridian Health campuses. This Reference Guide outlines specific instructions on registering for an account, accessing UpToDate, and earning and redeeming CME credits.

    If you have any questions, please contact Jersey Shore’s Booker Health Sciences Library at 732.776.4265 or jsumclibrary@meridianhealth.com.