Review:

• Had a lot of newborn respiratory issues
  • Not a lot of pneumonia
• Doing well with ASB/UTI
• Fluroquinolone use (mainly cipro)
  • in 90s, drug manufacturers promoted use
    • Good urinary penetration, but don’t need this level of antibiotic agent for uncomplicated UTI
  • Could be one provider
    • Go through cases and look who doctor was
      • Get list of visit numbers given cipro
    • 11 charts to look through
  • Ciprofloxacin – more at discharge, could be ED issue
• Show 11/15 presentation recording on medstaff

Goal:

• Evaluate fluroquinolone use and appropriateness for UTI and CAP
  • Focus on ED
    • Prescriber level data/peer comparison
• Get pharmacist to attend meetings and work as a team

Data collection:

• 3 urine cases per month
• Pneumonia:
  • Where can you get the data?
    • Assistant looks through reportable diseases daily
      • Reporting to public health, medstaff
      • Could pick out pneumonias during daily search
      • in-patient admits only
    • For ED – could look at ICD 10 codes
      • Assistant currently looks at chief diagnosis/complaint
  • Looking for any pneumonia
    • Should be enough to get 3 per month if ED is included
      • Look at ER tracking board daily – capture as they come in
    • Re-evaluate in a few months to see if meeting goals
    • Could look at lab department

Final data approach:

• Daily review of ED (track board) and inpatient (current process) to capture all pneumonia