Creutzfeldt-Jakob Disease: A Systems Approach in a Community Acute-Care Teaching Hospital

ISSUE: Many healthcare systems are unprepared to handle a complex infectious disease like Creutzfeldt-Jakob Disease (CJD). Early identification, diagnosis, handling of body fluids, and sterilization of surgical instruments are a challenge. An approach to control transmission of such a disease takes the coordination of many services in a health system to implement. PROJECT: The purpose of this paper is to outline the steps necessary for healthcare systems to take that will reduce the risk of healthcare-associated transmission of CJD or other CJD-like diseases. The research methodology used an extensive literature review. A multidisciplinary taskforce led by Infection Control was formed to include Surgery, Risk Management, Pathology, Laboratory, and Reprocessing department representatives. RESULTS: The taskforce identified and developed operational policy with resources necessary for early identification of a suspected case and a subsequent coordinated response. A risk assessment for use in the pre-surgical areas and other procedure intake areas was created. Actions were established if a suspected case should be identified. The use of disposable surgical instruments was implemented and an operating room clean-up kit was created to use after a case. An educational flyer was developed and distributed to clinical staff. LESSONS LEARNED: The project concludes that the ability of a healthcare facility to identify quickly a suspected or real case of CJD is paramount to reducing the victims of such an event. Operational policy must be implemented and recurrent education must be available for the intake clinical staff. Once the policies are developed and the equipment is obtained, the health system must test the system prior to an actual case as part of the process evaluation.