Description
Follow up on education from ASB 101 to review changes and evaluate changing UA reflex criteria.
Project Resources
Dayton final ASB Report 8.22.23
Core Elements
Education
Educating clinicians about resistance and optimal prescribing.
Reporting
Regular reporting information on antibiotic use and resistance to doctors, nurses and relevant staff.
Tracking
Monitoring antibiotic prescribing and resistance patterns.
PDSA Cycles
Progress on PDSA Cycle 1
Plan to change criteria/workflow (UA dip vs micro exam reflexing) and decide on new UA criteria
Get people on board
Plan to use Meditech Expanse AMS module to assist work
Check-in 2:
– Currently: UA dipstick with LE or Nitrates reflexes to culture (clinic). UA with any positive element (LE, nitrate, bacteria, WBC) reflexes to culture (in hospital)
– Change UA dipstick with LE or nitrates reflexes to microscopic UA eval. If UA has >5 WBC/hpf AND >=mod bacteria/hpf then reflex to culture. Karleen will take over data entry as Cheryl works to implement meditech expanse
Will change criteria
Had meeting/discussion about criteria changes
Train lab personnel on new criteria
Discuss during Medstaff after getting results
Check-in 2
- Interdisciplinary meetings/rounds 2x week (for AMS in general)
- Discussing during medstaff (monthly meeting) after getting results
- Implementing AMS module which will track and document IV to PO, alerts for results, and ongoing antibiotics x48hours (expected go live in Aug 2023)
4/11/23 New UA reflex criteria went live
Track how case numbers change after criteria change
Collect data on impact on treatment
4/27/23 Evaluate number of urine cultures before and after criteria change, Cheryl requested data from Monty on June 30th. Evaluate time to results and evaluate feedback from frontline providers.