1. Setting up an improvement project to reduce UTIs in your care home or region
Oxford

2. Getting Started At least 2 months before any changes are introduced
Start collecting baseline data using the monthly safety cross (print and populate the safety cross – a red sticker for any resident admitted to hospital with a primary diagnosis of a UTI, an orange sticker for a resident who has a UTI requiring antibiotics and a green sticker for no UTIs within the home that day).
Plan allocation of training for all member of staff (this takes 2 hours and should have a minimum of 10 people per session)
Two weeks before starting the seven structured drinks rounds
Put up the two posters around the residential/nursing home
Discuss project with staff and identify hydration champions to promote the study going forward
Allocate someone to collect the data to note if the change improve outcomes for residents
Put up posters to publicise the training and who is going when
Prepare the drinks folders with the Y/N sheet that staff will fill in to note if a drinks round has taken place or not ensuring you make the times of the 7 drinks rounds to fit in with your working day
Plan what will be on your drinks trolley and how the first one will be decorated (link with activities co-ordinator) – ensure that a variety of drinks and a variety of coloured cups, mugs, glasses will be available

3. Training
Undertake the training sessions ideally capturing majority of staff within a week so that they all know about it and are prepared for the start date when the drinks rounds are being introduced
Introduce 7 structured drinks rounds
Introduce the week after the training has taken place so that it is fresh in employees minds
Ensure all trolleys/dedicated drinks areas are decorated on day
Put the folder with the structured drinks sheet times and whether it was done or not (Y/N) on the bottom of the trolley or in a place where all staff know
Continue each week to keep creativity flowing – competitions between areas on the best trolley. New drinks for residents to try each week/month. Keep it “alive” through activities etc.

4. Measurement of outcome (reducing UTIs)
It is vital to measure the outcome (whether UTIs reduce or not) to ensure that improvement is being made
Allocated project nurse/carer to continue to fill in the safety crosses each month
Enter these UTI requiring antibiotics into the “days between UTIs” excel spread sheet.
The start date will be the day you start collecting baseline data and incident 1 will be the date of your first UTI requiring antibiotics or admission to hospital (there is a tab for UTI requiring admission to hospital and a separate tab for UTI requiring antibiotic)
The formula will automatically calculate how many days between incidents (UTIs) there has been. The aim is for more days between UTIs
Incident Date
Days since
Start Date
Incident 1
Incident 2
Incident 3

5. Measurement of process measures
The process measure is how many drinks rounds you achieve within each day – 7 each day = 100%
These can be recorded in the excel spread sheet “number of structured drinks rounds each week”
There are a maximum of 49 drinks rounds you can do within the week so if 39/49 are achieved
Enter the date, number of drinks rounds achieved each week i.e. 32/49 and it will automatically calculate the 65% of drinks rounds were achieved
Look to how you can improve this if not 100% (huddles with staff at handover for 5 minutes each morning to promote hydration, changing the time of a round if one time is always missed)
Please note 7 is the minimum number – continue to offer residents fluids in between these structured rounds.
Date
Number of drinks service per week
Number of total that could have been offered
Percentage Calculated
EXAMPLE 32 49
65.31%
01/01/2018
0.00%
08/01/2018
15/01/2018