Reducing inappropriate and contaminated urine cultures through a bundle prevention package with a focus on patient and staff knowledge

Fiona Hamilton¹, Michelle Hudoba¹

¹Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia

Background
The incidence of hospital acquired urinary tract infections remain at a higher than state average in the local health district. In addition, pathology results high-lighted the need to improve the quality indicators related to urine specimens. The aim of the project is to evaluate the impact of a quantitative interventional study on the number of inappropriate and contaminated urine cultures collected.

Method
The study includes a threefold improvement strategy involving a bundle intervention. The bundle will focus on staff knowledge, patient urine collection and the provision of skin wipes. Staff knowledge of the clinical indicators and documentation required to collect urine cultures will be assessed pre and post the project commencement.

The project will take place in two separate hospitals with six speciality wards including- Rehabilitation, Palliative care, Aged care, Medical and Emergency Medicine. Pre implementation, retrospective pathology data of urine cultures over a six month period will be analysed. This will be compared to six month period of pathology data of urine cultures post implementation.

Results
The expected results include a reduction in contaminated and inappropriate urine cultures, increased staff knowledge of the clinical indicators for collecting urine cultures. Staff surveys should indicate improved knowledge of required documentation, including patient education when collecting a urine sample.

Conclusion
On the conclusion of this project, it is expected the focus on staff and patient education will lead to improved quality of urine specimens submitted for culturing and a reduction in pathology costs.

Biography

Fiona Hamilton qualified as registered nurse in Sydney, NSW in 1986 and first moved into the field of infection prevention and control in 2018. Fiona is currently practising as Clinical Nurse Consultant and is a member of the Illawarra Shoalhaven Local Health district infection management and control service (IMACS). This role requires infection control consultancy to several inpatient facilities and associated community health services including oral health, drug and alcohol and other community health services.