6/20/24 Check-in:

• Reviewed data report
  • No fluoroquinolones being used
  • Good inappropriate UTI measure, prevalence and treatment
  • Some receiving over 7 days of treatment – plan address duration

First Check-in:

Facility background 

• Anna – Infection preventionist – 1 year
• Andrea – Director of pharmacy – 36 years
• 600 staff members
• Do ortho, urologist, gyn, general surgery – Davinci robot
• Pullman – WSU largest employer, Engineering other large employer
  • Get people traveling internationally, athletes
• Spokane main referral point
• Struggle with ID consults
• Have resident program

AMS

• Internist doc – AMS physician lead
• Good amount of abx go through contracting group
• Urology – large use of quinolones
• Not reporting to NHSN – changed to Epic a year ago
  • Providence version
  • Will be getting set up with Sentri 7 – plan to get AUR organized this next year
• Blood cultures sent out, urines done at facility
• Have leadership support – concerned about AUR reporting
• Seems ER has reduced amount of cipro being sent out for UTIs

Data collection 

• Clinics and in-house
  • Some don’t use electronic charting (OB) – skip over some types of patients – would be excluded anyway
  • Gynecology also excluded
• Inputting partial records – not enter this data as it may skew data
  • Cannot see why urinalysis is ordered
• Seems like there is no reason indicated for urine culture
  • Exactly type of case you would want to include
• To get data – pull report of all cultures (urine and not)
  • Check each chart to see if patient qualifies to be entered
  • Including urine culture with no growth or mixed growth
  • Only not doing if they don’t have data for the questions

Second check-in – 1/25/24:

Data collection:

• Data collection SMART goal: Meet once a week to enter 4-5 cases per week
  • Randomly select patients based on date
• Had some questions
  • In-dwelling catheter or other relevant details for case (spasm in abdomen or upper leg) – no place to document
    • If data does not fit into categories, would consider asymptomatic (does not meet definition we are using, need to be consistent)
  • Do have a patient that does have a spinal cord injury and shooting pain, patient considers this UTI symptom
    • Highlight patient on personal tracking sheet
  • Identifies one bacteria and also mixed flora/another bacteria in finaled
    • Reasonable to call this single bacteria
    • Be consistent with decision
• Have been checking providers before opening charts to avoid OBGYN

Next steps:

• Noticed that UAs are being sent with no indication
• No SMART goal yet
  • Possibly focus on sending test out in first place
• Want to look at best approach
  • Get physician on board to not run urines without symptom