Description
Facility Background
- 20 bed critical access hospital
- Acute care, ICU, ED, rural health clinic, specialty clinic (ortho and general surg), radiology lab
- Most tests done by Quest – send out
- Urinalysis, dipsticks – done in house
- Wound, urine, blood cultures processed through Bay Area hospital
AMS
- Coe – physician AMS champion (family medicine – outpatient clinic – rep for a group)
- Lana – Director of Pharmacy
- Jason – in patient pharmacist, has some stewardship experience from residency
- Jennifer – CNO
- Ashley – clinical informatics
- Monthly meetings
- Made some order sets – Sepsis, C diff
Project Resources
Lower Umpqua 04-2024 ASB 101 Report_0
Core Elements
Education
Educating clinicians about resistance and optimal prescribing.
PDSA Cycles
Progress on PDSA Cycle 4
Working with stewardship team to publish facility-level guidelines for treatment
Progress on PDSA Cycle 3
5/2/24 Check-in
- Reviewed April data report
- Slightly higher inappropriate diagnosis of UTI measure compared to cohort
- Using first line antibiotics like Nitrofurantoin, not using fluoroquinolones
- Antibiotic duration is higher
Your organization has completed the following PDSA cycles. Click a heading to view a cycle's details.
2/1/24
Optimize data collection program
We will meet with lab personnel to better identify patients with urine cultures and complete clinical data. In order to do this we will determine if patient can be screen with those with either an in system provider or an active encounter at the time of urine collection.
Reviewed exclusions from data submission
One prescriber ordering urine cultures with no notes
Were able to submit sufficient data
Data Collection
- IQIC – have figured out how to collect data as a team approach
- Will pick random sample and nursing and pharmacy will collaborate to enter data
- Needed lab collaboration to get data from Quest – were able to figure out report to run and get random sample
- Aiming for 5 cases/month
- Do not pick for cases with positive cultures, abx prescribed
- Add fluconizole to list of antimicrobials
2/1/24
Data collection going very smoothly, cases matching goal set in Oct. Hit goals outlined in plan.
Selection of patients needs to be optimized. Random selection ends up including patients who have incomplete clinical data.
Next steps: meet with lab and team to plan next steps.