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Regional Infection Prevention & Control

Regional Infection Prevention & Control. Urine Culture: Making it Count Marilyn Weinmaster Infection Control Practitioner Long Term Care, RQHR. Acknowledgement. Dr. Meredith Faires Epidemiologist, Regional Infection Prevention and Control, RQHR. Presentation Outline.

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Regional Infection Prevention & Control

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  1. Regional Infection Prevention & Control Urine Culture: Making it Count Marilyn Weinmaster Infection Control Practitioner Long Term Care, RQHR

  2. Acknowledgement Dr. Meredith Faires Epidemiologist, Regional Infection Prevention and Control, RQHR

  3. Presentation Outline • RQHR Long Term Care Urinary Tract Surveillance • RQHR Demographics • Definitions • Facilities • Surveillance results • Limitations • Future strategies

  4. Demographics

  5. Demographics • 23 Long Term Care Facilities(LTCFs) • 14 RQHR • 9 affiliates • 14 rural • 9 urban • Beds • 2000 • Range 10-321 beds

  6. UTI Surveillance and Criteria • Surveillance Definitions of Infections in Long-Term Care Facilities: Revisiting the McGeer Criteria (SHEA, 2012) • Additional information collected: • Who: Assessment and Collection • Reason C&S collected • Contaminated specimen

  7. UTI Collection Form • ..\..\..\..\LTC - UTI - Facilities without an addressograph .pdf

  8. UTI Surveillance Descriptive Statistics • 2014 – 2016 surveillance period • 18facilities participated • Urban, rural, and affiliates • 2111 urine specimens + data collection form • 1609 (76%) WITHOUT a urinary catheter • 502 (24%) WITH a urinary catheter • C&S submission and UTI identified by month

  9. UTI Surveillance Descriptive Statistics • 2014 – 2016 surveillance period • 18 facilities participated • Urban, rural, and affiliates • 2111 urine specimens + data collection form • 1609 (76%) WITHOUT a urinary catheter • 502 (24%) WITH a urinary catheter • C&S submission and UTI identified by month • Reasons for urine C&S

  10. UTI Surveillance Contamination • Contamination reported for 2015 – 2016 • 835 urine specimens with forms • 269 (32%) urine specimens contaminated • 197 (73%) WITHOUT a urinary catheter • 72 (27%) WITH a urinary catheter

  11. UTI Surveillance Laboratory Costs • Costs for processing a urine C&S: $42.80 • Surveillance period: 2014 - 2016 • All urine specimens: $90,350.80 • Symptomatic residents: $48,792.00 • UTI identified: $16,135.60 (18% of overall cost) • All other reasons: $41,558.80 • Contaminated (2015 – 2016): $11,513.20

  12. UTI Surveillance Limitations • Passive surveillance • Not all 23 LTC sites participate • Labeling C&S lab reports • Data error: lab req & collection tool • Following “Golden Rule” of 80% • <80% No report is generated • ≥80% Report is generated

  13. UTI Surveillance Future Strategies • Reduce limitations • Number of urine C&S submitted • ..\..\..\..\ABCsForDiagnosingUTIsInContinuingCare.pdf • Education: ICP, CNE- MOH tool, specimen collection, contamination, cost • Abide by the 80% • Presentations to staff • Provide quarterly “80% rule” table • Labeling C&S Reports: Site not “REF” • Pilot Project on a unit • Address #1 (intervention): will the # of urine specimens, contamination, cost decrease? • Compare 6 month pre-intervention with 6 month post-intervention

  14. Thank You

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