Improving Evaluation and Treatment of UTI’s in the Elderly through Antibiotic Stewardship Patricia Nnaji, NPE, IC, RN June 18, 2013 Elaine Center for Hadley/Genesis Healthcare 20 North Maple Street Hadley, MA 01035 Phone: 413-584-5057

Goals To examine our skilled nursing practices today, and ensure that our current surveillance, diagnosis and treatment of Urinary Tract Infections (UTI’s) are in line with best in class practices. To become involved with a collaborative approach to antibiotic stewardship, and build relationships with our community of healthcare providers. To learn! Patricia Nnaji, NPE, IC, RN June 18, 2013

How It is Going… Improved Trends: Data trends show that, beginning February, 2013, a greater percentage of LTC residents with UTI’s met the revised McGeer's assessment and treatment protocol. Improved Accuracy: Urine testing rates declined as the quality of assessments and symptom management improved. Education is Key: Case reviews yielded opportunities to avoid misuse of antibiotics. Patricia Nnaji, NPE, IC, RN June 18, 2013

How It is Going… (cont.) CUT AND PASTE GRAPH

What We Did… Planning and Education: Facility nurse management, and MD/NP’s, attended the UTI program meetings and or webinars. We strategized and followed with nursing staff education. Do: Applied the revised McGeer's in a comprehensive yet simplified “ABC” format. Check: Monitored and measured UTI assessment and treatments, on a daily, weekly, and monthly basis. Act: Reeducated and revised strategies based on trends. Patricia Nnaji, NPE, IC, RN June 18, 2013

What Seemed to Matter… the “AHA!” MOMENT getting… The defining moment of sudden realization, inspiration, insight or comprehension, that made it easy for healthcare care staff to remember and want to apply a revised clinical process. From staff to family members, we got it! Patricia Nnaji, NPE, IC, RN June 18, 2013

Challenges as we Move Ahead Patricia Nnaji, NPE, IC, RN June 18, 2013