“I don’t get calls like that anymore.” Cheryl Kowalski, RN Heritage Hall North Staff development and education / Infection Prevention

GOALS Educated nurses using “Prudent Use of Antibiotics In Treatment of Urinary Tract Infections” Stopped dipping urine Initiated the “DELIRIUMS” tool Initiated dialogue with Medical Director and Nurse Practitioners Goal: Reduction of total urine cultures per month by 50% over 6 month period

RESULTS Jan 2012 through Oct 2012 total urine cultures per month averaged 27 Nov 2012 through April 2013 total urine cultures per month averaged 15 Total urine cultures per month have decreased by 50% Antibiotics are not being prescribed prior to culture results Urine dips are no longer part of our practice

PROGRESS Nurses complete SBARs prior to notifying MD of s/s UTI Nurses assess using the ‘DELIRIUMS” tool Ongoing dialogue with Regional Medical Director, Facility Medical Director, Nurse Practitioners, Director of Nursing, Nurse Managers and Nurses Daily infection control surveillance and unit rounds Infections and clinical changes reviewed daily at morning meeting

EDUCATION DIALOGUE SURVEILLANCE

PLAN Continued reduction of urine cultures per month via ongoing dialogue with the team to increase the level of awareness of overdiagnosis and over treatment of UTIs and improvement in nursing assessment and reporting.