Infection Control & Hospital Epidemiology Table 3. (Continued )


Implementation Strategy


Classroom education


Description


Delivering education about the issues of treating ASB and desired practice changes.


Target Audience/Details on Delivery


Target audience: Education would serve frontline staff (eg, personal support workers, nursing staff) When/How often: Delivered once at program initiation Applicable PHO resources: LTCF staff deliver their own education with resource support (ie, assessment algorithm for UTIs in medically stable noncatheterized residents, fact sheets, literature summary resources, Frequently Asked Questions resource, and PowerPoint slides).


Providing


information and


education to families


Distributing resources and providing education to families and residents (eg, family council)


Target audience: LTCF residents and families When/How often: Includes formal sessions on an ad-hoc basis (aligned with existing family council meetings) and as opportunities arise to educate and share resources with families. Applicable PHO resources: Frequently Asked Questions for residents and families, resident and family communication form, and communication for family newsletter


Coaching


Selecting front-line staff to provide one-on-one education, feedback and support to peers


Target audience: All frontline staff within the LTCF When/How often: Ongoing Resources: Coaching for beliefs and consequences resource, assessment algorithm for UTIs in medically stable noncatheterized residents, fact sheets, and Frequently Asked Questions resource


Process surveillance


A process that involves documenting resident symptoms, whether a urine specimen was collected, and whether antibiotics were prescribed; reviewing the data for alignment with practice changes; and providing feedback to staff on opportunities for improvement


Distributing educational resources as reminders


Redistribution and posting of program resources (eg, “when to collect a urine specimens” fact sheet) to remind staff about practice changes


Target audience: Staff providing care to residents in the assessment and management of UTIs When/How often: Monitoring practice and providing feedback should be done regularly during program initiation. Improvements to overall documentation of symptoms and communication is an ongoing process. Applicable PHO resources: Process surveillance form


Target audience: Staff providing care to residents in the assessment and management of UTIs When/How often: Ad-hoc when reminders needed Applicable PHO resources: A number of PHO program resources can be used as reminders to support practice change, eg, “when to collect a urine specimen,” assessment algorithm for UTIs in medically stable noncatheterized residents, Frequently Asked Questions, and fact sheets


Rationale and Benefits


Provides dedicated time to increase staff knowledge on the problem and best practices


∙ Helps to secure buy-in to the practice recommendations


∙ Supports staff skill in the proper collection of urine specimens


∙ Increases awareness of new policies and procedures including documentation and communication of resident symptoms and roles and responsibilities


∙ Addresses beliefs and concerns about the consequences of not providing antibiotics to residents with nonspecific symptoms


∙ Reviews practices that may be contributing to the overuse of urinary antibiotics


∙ Addresses family pressures to prescribe antibiotics despite the absence of accepted signs and symptoms of a UTI


∙ Supports opportunities to increase knowledge on the problem, best practices and organizational policies and procedures


∙ Addresses beliefs and concerns about the consequences of not providing antibiotics to residents with nonspecific symptoms and emphasizes ongoing monitoring of the resident and the risks of unnecessary antibiotics


∙ Supports opportunities to reinforce education on the problem, best practices (can involve staff who are missed by classroom education), and any new procedures


∙ Helps others address beliefs and concerns about the consequences of not providing antibiotics to residents with nonspecific symptoms


∙ Helps secure buy-in to the practice recommendations


∙ Aids the monitoring of adherence to best practices ∙ Helps establish a supportive organizational culture for the practice changes


∙ Supports improved communication amongst the care team regarding resident symptoms and helps support UTI surveillance activities


∙ Can be used to monitor and make ongoing improvements to practice changes


29


∙ Provides an additional opportunity to increase staff knowledge and/or remind staff on best practices, addressing beliefs about the consequences of not providing antibiotics to residents with nonspecific symptoms, and reminding staff about new policies and procedures for documenting and communicating resident symptoms


Note. LTCF, long-term care facility; PHO, physician hospital organization; ASB, asymptomatic bacteriuria; UTI, urinary tract infection.


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76  |  Page 77  |  Page 78  |  Page 79  |  Page 80  |  Page 81  |  Page 82  |  Page 83  |  Page 84  |  Page 85  |  Page 86  |  Page 87  |  Page 88  |  Page 89  |  Page 90  |  Page 91  |  Page 92  |  Page 93  |  Page 94  |  Page 95  |  Page 96  |  Page 97  |  Page 98  |  Page 99  |  Page 100  |  Page 101  |  Page 102  |  Page 103  |  Page 104  |  Page 105  |  Page 106  |  Page 107  |  Page 108  |  Page 109  |  Page 110  |  Page 111  |  Page 112  |  Page 113  |  Page 114  |  Page 115  |  Page 116  |  Page 117  |  Page 118  |  Page 119  |  Page 120  |  Page 121  |  Page 122  |  Page 123  |  Page 124  |  Page 125  |  Page 126  |  Page 127  |  Page 128  |  Page 129  |  Page 130  |  Page 131  |  Page 132  |  Page 133  |  Page 134  |  Page 135  |  Page 136