Ms Adele Wilkinson1
1Anglicare Southern Queensland, Bundaberg, Australia
In October 2021, we seized the opportunity offered by the Aged Care Quality and Safety Commission (ACQSC) to participate in ‘To Dip or Not to Dip’ (TDONTD), a quality improvement activity implemented by on-site RACF nurse champions. The aim is to promote and support best practice management of suspected Urinary Tract Infection (UTI) by increasing clinical staff education (1) in recognising UTI and (2) pitfalls of urinalysis, including the potential indiscriminate antimicrobial treatments which often follow a dipstick result.
As facility manager, I implemented TDONTD in October 2021 when staff attended a case-based education session. In November, we instigated the use of the clinical pathway for all assessment and clinical communications for suspected UTI. Staff were encouraged to consider this tool as “best practice on a page”, with the pathway highly visible and available. Hanging blank copies next to our fax machine promoted pathway use for communication with GPs. As Champion, I committed time each day to remind staff to use TDONTD. We celebrated our success for each UTI ‘managed appropriately’ at all clinical meetings. Antibiotic audits were performed at baseline and at 3-months.
By March 2022, nurse-initiated urinalysis practice had changed significantly, and staff were more confident in using the pathway without prompting. Improvements in antibiotic prescribing practice was seen in follow-up auditing in our RACF.
In implementing TDONTD, we achieved sustained system change by seizing the right opportunity, change leadership, and teamwork. We are not only promoting better resident care, but also actively participating in sustainable Antimicrobial Stewardship.
Biography: I have had an extensive career in nursing, having held advisory and executive leadership roles in both acute and aged care settings. For the past 20 years I have lived and worked in the regional town of Bundaberg Queensland, where I currently manage an 88-bed Aged Care facility. My life-long passion for exploring improvements in healthcare delivery inspires me each day to motivate others, and to influence positive change wherever possible.