Description
Identify UAs and reduce unnecessary UA screening in pre surgical patients.
Minidoka final ASB Report 8.22.23
Core Elements
Accountability
Appointing a single leader responsible for program outcomes. Experience with successful programs show that a physician leader is effective.
Action
Appointing a single leader responsible for program outcomes. Experience with successful programs show that a physician leader is effective.
Drug Expertise
Appointing a single leader responsible for program outcomes. Experience with successful programs show that a physician leader is effective.
Education
Educating clinicians about resistance and optimal prescribing.
Leadership Commitment
Dedicating necessary human, financial and information technology resources.
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 2
- Education in ED
- Collect data
- Decrease duration of treatment of ASB on total knees.
Fall of 2022
- Discussed with ED lead on abx and continue to hand deliver abx to ED nursing staff and discuss with physician type of abx.
- Individually reaching out to new staff to build rapport.
- Modify UTI abx order for pre-op patients
April Check-in
1. Continuing as of 4/27
2. 3 new ED physicians have joined – Wesston introduced & new hospitalist joining soon (will try to establish rapport)
3. Cannot make progress on pre-op orders – may not be feasible. Data has been presented by NP student, but surgery not interested. Most patients are leaving before receiving all 6 doses post-op.
4. Received report from 201 team – shared with lead physician who passed on information to staff
Switching software to Epic in June
April Check-in
- Abx started in ED are being continued
- Data collection of urinary continued
- Case analysis: clogged catheter leading to UTI, most recent 2 cases showed appropriate UTI prescription
Your organization has completed the following PDSA cycles. Click a heading to view a cycle's details.
Met with lab to gather data.
Lab collected a 3 month window, 400 UA in 3 months and 168 reflexed to culture. (ED only, not surgical)
Found opportunity (during quarterly abs meeting and head surgical nurse included in meeting. Nick described ASB project and nurse mentioned the outpatient testing and prescribing) due to lots of UA screening in surgical. Almost 100% tested and if found, treated. Plan in place to address with presentation to surgical committee in June 29, 2022.
Suggestion from surgeon to TASP: TASP faculty attend the June meeting to surgical team.
Learned: Outpatient prescribing Nick and team was unaware of
Can lab provide/identify which surgeon prescribing and how often?
Presented data to surgeons