MDS Alert
Home In on a High Rate of UTIs
Here's what to do if you note a worrisome pattern.
Assuming the urinary tract infection QI/QM isn't high due to inaccurate reporting, look to see if the infections are related to Foley catheters, advises Daniel Haimowitz, MD, CMD, in Levittown, Pa. If so, target problems with caregivers' techniques for inserting and maintaining the catheters, including poor handwashing, failure to keep the sterile system closed, and "inappropriate Foley flushing, etc.," he advises. Also look to see if the catheter use is clinically appropriate based on F315 survey guidance (www.cms.hhs.gov/manuals/Downloads/som107ap_pp_guidelines_ltcf.pdf).
As for non-Foley UTIs, assess whether the patients are at higher risk for UTI, Haimowitz suggests. Perhaps there wasn't a "good enough work-up for residents with other urologic problems that predispose to UTIs." Also look to see whether patients with UTI have poor hydration, he suggests. Are caregivers teaching patients to cleanse properly after using the toilet? Haimowitz asks.
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