Impact of mandatory nucleic acid amplification test (NAAT) testing approval on hospital-onset infection (HO-CDI) rates: A diagnostic stewardship intervention.

Misclassification of colonization as hospital-onset infection (HO-CDI) can lead to unnecessary treatment of patients and substantial financial penalties for hospitals. We successfully implemented mandatory PCR testing approval as a strategy to optimize testing, which was associated with a significant decline in the monthly incidence of HO-CDI rates and lowering of our standardized infection ratio to 0.77 (from 1.03) 18 months after this intervention. Approval request served as an educational opportunity to promote mindful testing and accurate diagnosis of HO-CDI.