Description
TBD
Project Resources
Lincoln 1-23-24 Report
Core Elements
Education
Educating clinicians about resistance and optimal prescribing.
PDSA Cycles
Progress on PDSA Cycle 3
Long duration of therapy presented as a recurring trend with ED prescribing for UTI’s in the ED.
IQIC data showed the following.
Number of Cases Receiving >7 days for UTI about 30%
Number of cases receiving > 7 days for ASB – 27-45%
This prompted us to put all data into a pivot table to look at specific provider data.
Specific provider data from the ED revealed:
Cephalexin was definitely the most heavily prescribed antibiotic
NO Rx’s for nitrofurantoin for UTI have been prescribed out of the ED
11 prescribers (4 local, 7 locums) were included with the data assessment
Looking at the AVERAGE duration of therapy by provider/drug – ZERO providers averaged the recommended duration of treatment when prescribing.
A power point was put together to provide education to the medical staff.
Locum attendance at the medical staff meeting is quite good, so I have requested time to present some background, a recap on ASB, and the data we have gathered for this project.
Progress on PDSA Cycle 2
Assessing Locum Prescribing habits from the ED for UTI patients.
Submit data to IQIC gathering tool and determine where focus should be
YTD Crystal has added 133 entries into the IQIC data calculator. 47 of these were ED only which provided a good representation of in-house and locum prescribing practices.
This data will now be placed into pivot tables and analyzed for trends.
Progress on PDSA Cycle 1
- For awhile, wasn’t getting any clinic cultures
- Clinic will be focus
- Switched Meditech to Epic in June
- Have been trying to figure out Epic reporting
- 4 cultures came through – all 4 not prescribed anything
- ER also seems to be area of focus – lots of locums
- Locums happy to hear suggestions, receptive
- Need to put together data/info in easy to understand format to present (short presentation)
- Need to meet together to look through charts
- Merilla can help enter some of the data
- Morgan helping, have system
- Plan to submit around 150 cases – 50/50 ER and clinic
- Seems like people aren’t ordering as many UAs now
- Still doing daily AMS activities, but not working on major stewardship
- Questions: Some patients come in 2-3 times for UTI a few months apart – have different bacteria and get treated – should they be entered?
- Yes, with different patient ID
- Would be easier to not try to look if patient is repeat – every case, unique #