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Educational intervention to reduce treatment of asymptomatic bacteriuria in long-term care

OBJECTIVE: To determine if an educational intervention can decrease the inappropriate antibiotic treatment of long-term care (LTC) residents with asymptomatic bacteriuria (ASB). DESIGN: Prospective chart audit between May and July 2017. SETTING: Seven LTC facilities in Regina, Saskatchewan, Canada....

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Autores principales: Lee, Christine, Phillips, Casey, Vanstone, Jason Robert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6280905/
https://www.ncbi.nlm.nih.gov/pubmed/30588518
http://dx.doi.org/10.1136/bmjoq-2018-000483
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author Lee, Christine
Phillips, Casey
Vanstone, Jason Robert
author_facet Lee, Christine
Phillips, Casey
Vanstone, Jason Robert
author_sort Lee, Christine
collection PubMed
description OBJECTIVE: To determine if an educational intervention can decrease the inappropriate antibiotic treatment of long-term care (LTC) residents with asymptomatic bacteriuria (ASB). DESIGN: Prospective chart audit between May and July 2017. SETTING: Seven LTC facilities in Regina, Saskatchewan, Canada. PARTICIPANTS: Chart audits were performed on all LTC residents over 18 years of age with a positive urine culture. Educational sessions and tools were available to all clinical staff at participating LTC facilities. INTERVENTION: Fifteen-minute educational sessions were provided to LTC facility staff outlining the harms of unnecessary antibiotic use, antibiotic resistance and the diagnostic criteria of a urinary tract infection (UTI). Educational sessions were complimented with posters and pocket cards that summarised UTI diagnostic criteria. MAIN OUTCOME MEASURE: The primary outcome measure was the number of residents who received inappropriate antibiotic treatment for ASB. Secondary outcome measures included the appropriateness of urine culture tests, number of tests and cost associated with inappropriate treatments. RESULTS: In the preintervention period, 172 urine culture and sensitivity (UC&S) tests were performed, 62 (36.0%) were positive and 50/62 (80.6%) residents had ASB based on chart review. In the postintervention period, 151 UC&S tests were performed, 50 (33.1%) were positive and 35/50 (70.0%) residents had ASB. There was a statistically significant decrease in the number of residents treated with antibiotics for ASB, from 45/50 (90%) preintervention to 22/35 (62.9%) postintervention (χ(2)=9.087, p=0.003). CONCLUSIONS: An educational intervention was associated with a statistically significant decrease in inappropriate antibiotic treatment of LTC residents with ASB.
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spelling pubmed-62809052018-12-26 Educational intervention to reduce treatment of asymptomatic bacteriuria in long-term care Lee, Christine Phillips, Casey Vanstone, Jason Robert BMJ Open Qual Original Article OBJECTIVE: To determine if an educational intervention can decrease the inappropriate antibiotic treatment of long-term care (LTC) residents with asymptomatic bacteriuria (ASB). DESIGN: Prospective chart audit between May and July 2017. SETTING: Seven LTC facilities in Regina, Saskatchewan, Canada. PARTICIPANTS: Chart audits were performed on all LTC residents over 18 years of age with a positive urine culture. Educational sessions and tools were available to all clinical staff at participating LTC facilities. INTERVENTION: Fifteen-minute educational sessions were provided to LTC facility staff outlining the harms of unnecessary antibiotic use, antibiotic resistance and the diagnostic criteria of a urinary tract infection (UTI). Educational sessions were complimented with posters and pocket cards that summarised UTI diagnostic criteria. MAIN OUTCOME MEASURE: The primary outcome measure was the number of residents who received inappropriate antibiotic treatment for ASB. Secondary outcome measures included the appropriateness of urine culture tests, number of tests and cost associated with inappropriate treatments. RESULTS: In the preintervention period, 172 urine culture and sensitivity (UC&S) tests were performed, 62 (36.0%) were positive and 50/62 (80.6%) residents had ASB based on chart review. In the postintervention period, 151 UC&S tests were performed, 50 (33.1%) were positive and 35/50 (70.0%) residents had ASB. There was a statistically significant decrease in the number of residents treated with antibiotics for ASB, from 45/50 (90%) preintervention to 22/35 (62.9%) postintervention (χ(2)=9.087, p=0.003). CONCLUSIONS: An educational intervention was associated with a statistically significant decrease in inappropriate antibiotic treatment of LTC residents with ASB. BMJ Publishing Group 2018-12-01 /pmc/articles/PMC6280905/ /pubmed/30588518 http://dx.doi.org/10.1136/bmjoq-2018-000483 Text en © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Original Article
Lee, Christine
Phillips, Casey
Vanstone, Jason Robert
Educational intervention to reduce treatment of asymptomatic bacteriuria in long-term care
title Educational intervention to reduce treatment of asymptomatic bacteriuria in long-term care
title_full Educational intervention to reduce treatment of asymptomatic bacteriuria in long-term care
title_fullStr Educational intervention to reduce treatment of asymptomatic bacteriuria in long-term care
title_full_unstemmed Educational intervention to reduce treatment of asymptomatic bacteriuria in long-term care
title_short Educational intervention to reduce treatment of asymptomatic bacteriuria in long-term care
title_sort educational intervention to reduce treatment of asymptomatic bacteriuria in long-term care
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6280905/
https://www.ncbi.nlm.nih.gov/pubmed/30588518
http://dx.doi.org/10.1136/bmjoq-2018-000483
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