Practice Overview - Highlight Park Practice
- One of 7 GP practices in Barry
- Practice Population of 7,186
- Total population of Barry 57,000
- Situated in the north of the town
UTI Program Improvement Objectives:
- To reduce unnecessary prescribing
- To improve the quality urine sampling and remove asymptomatic bacteria
- To reduce over-ordering of diagnostic cultures
Urinary tract infection (UTI) is one of the most common indications in the community setting for
which antimicrobials are prescribed. Patients are frequently screened, some would say overscreened, by means of obtaining urine cultures when not clinically indicated during the nurse or GP
appointment because of the presence of asymptomatic bacteriuria.
Patient specimens can be contaminated during the collection process, this could be due to a
combination of unhygienic handling, the use of non-sterile containers and the elapsed time from the
specimen being collected to being decanted into a sterile container with preservative.
What currently happens:
- Patients with signs or symptoms of suspected UTI treated on-site or have a antimicrobial
prescription provided following telephone consultation
- Patients would bring urine sample to the surgery
- The specimen age was unknown / not recorded
- Nonsterile containers were being used by patients
- Specimens unlikely to the clean catch
- High number of urine specimens were decanted following dip and sent for culture
Improvement programme methods:
- All patients that call or present with signs or symptoms of suspected UTI were triaged using
the UTI triage form.
- Patients that were required to provide a urine sample, were invited to the practice where
the sample was provided using the Peezy device.
- Patients arriving with samples already collected outside of the surgery were required to
provide a fresh sample using the Peezy prior to their consultation with the ANP or GP.
- If the triage algorithm indicated a culture was required, the patient would provide a urine
specimen using a Peezy device with a universal tube containing boric acid (PE41).
- If the triage algorithm indicated the specimen should be dipped first, the patient would
provide a urine specimen using a Peezy device without non-boric universal tube (PE40).
- In both instances the during the triage process the time the sample was provided by the
patient was recorded.
Improvements Achieved:
- Practice staff were able to better assess and confirm the appropriateness of treatment
- Practice staff were able to better asses patient dip tests in the absence of symptoms to
identify the likelihood of asymptomatic bacteria
- Practice staff were more confident pausing antimicrobial prescribing whilst awaiting the
results from laboratory cultures or microscopy
- Practice staff identified improved workflows
- Patient hygiene was improved using the Peezy
- The Peezy device removes handling issues, urine splashback and spills
- The laboratory was able to measure the true elapsed time from specimen collection to
analysis.
- Practice staff identified that certain patients with a history of recurrent, chronic and
complicated conditions were correctly diagnosed improving treatment outcomes
Feedback provided by project lead :
Using the Peezy device in clinical practice has allowed us to completely transform how we approach
caring for patients presenting with UTI symptoms. Care is now streamlined, avoiding the need for
repeat samples and avoiding mixed growth culture results; meaning antibiotic prescriptions are far
more appropriate. As a surgery it has allowed us to empower the non-clinical team to provide
patients with clear and concise information at their first point of contact with the surgery. The
advice given to patients is consistent due to the use of algorithms and scripts, and coupled with the
Peezy device, has improved patient care dramatically. From a clinical perspective we have seen the
number of prescriptions for antibiotics reduce as well as the number of mixed growth culture
results; we are able to get the best outcomes for our patients in the quickest and safest manner.
You can read and download the paper, with the full results and discussion HERE
You can find further information regarding product used in this practice evaluation via this link https://forte-medical.co.uk/