Successful outcomes

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• Reduction of samples

• Code for patients treated in pharmacies so can calculate how many are being done elsewhere

• Template on Front Desk appointments – saves nurse time

• Clear audit trail on urines tested

• If Primary Care Practitioners or GPs request a test – these are all put on the same list and put on the screen to ensure that they have been received

• Always able to find the results for patients.  Saves time for patients and for staff

• Following the clear guidelines reduces unnecessary testing

• Immediate treatment for patients who could be more complex e.g. men, pregnant woman, children, patients on warfarin, LTC, 3 or more positive blood samples

• A great piece of joint working with a GP, nurse, pharmacist, admin and clerical team.   The admin and clerical team has taken responsibility to support clinical team which has made everyone’s job much easier, slicker and safer

• Patients coming back with symptoms and whose sample is negative are booked in for a face to face appointment.  This has caught a range of health problems earlier eg. STIs and bladder cancer.

 

Why we had to change

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We have a high population of elderly thus resulting in a high level of urine infections.  Also, some patients can present with additional problems that are not related to a urine problem.

 

We have up to 5000/year which meant that the nurse was struggling to cope with the demand. 

 

What we did

 

We pulled together a team of a lead GP, our in-house pharmacist who treats UTI’s, a member of the admin staff and a nurse.  We developed a set of new clear guidelines based around the NICE guidelines for all staff in each staff group.  These guidelines were put on file with easy access for staff who are encouraged to become familiar with them.  Staff are given a copy when inducted on infection.  We are able to keep track of those not accessing the guidelines and then we encourage them to do so. 

 

The guidelines for the reception team are based on the pharmacy MAS and they are then able to direct patients onto them. 

 

The template fills the whole screen so that all of the possible problems are checked and completed.

 

Patients are asked to complete a form asking for their symptoms.  In the past, patients often did not do this and left it to clinical staff.  We now encourage patients to do this prior to appointment and explain why.  This has reduced any unnecessary chasing by GPs or other clinicians.