1. Regional Infection Prevention & Control
Urine Culture:
Making it Count
Marilyn Weinmaster
Infection Control Practitioner Long Term Care, RQHR

2. Acknowledgement
Dr. Meredith Faires
Epidemiologist, Regional Infection Prevention and Control, RQHR

3. RQHR Long Term Care Urinary Tract Surveillance
Presentation Outline
RQHR Long Term Care Urinary Tract Surveillance
RQHR Demographics
Definitions
Facilities
Surveillance results
Limitations
Future strategies

4. Demographics

5. 23 Long Term Care Facilities(LTCFs)
Demographics
23 Long Term Care Facilities(LTCFs)
14 RQHR
9 affiliates
14 rural
9 urban
Beds
2000
Range beds

6. UTI Surveillance and Criteria
Surveillance Definitions of Infections in Long-Term Care Facilities: Revisiting the
McGeer Criteria (SHEA, 2012)
Additional information collected:
Who: Assessment and Collection
Reason C&S collected
Contaminated specimen

7. ..\..\..\..\LTC - UTI - Facilities without an addressograph .pdf
UTI Collection Form
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8. UTI Surveillance Descriptive Statistics
2014 – 2016 surveillance period
18 facilities participated
Urban, rural, and affiliates
2111 urine specimens + data collection form
1609 (76%) WITHOUT a urinary catheter
502 (24%) WITH a urinary catheter
C&S submission and UTI identified by month
:18/23 LTCF participated
: 19/ affiliates chose not to participate

9. Say the title
Explain the x (month and year) and y axis = the Y represents the number of specimens submitted to lab with a surveillance data collection tool
What the blue and green line represent
What is the graph showing us: Over the surveillance period the number of urine specimens submitted to the laboratory has decreased. I will elaborate on this finding later on in the presentation.
For the number of UTIs identified, this number is substantially lower than the numbers of specimens submitted, however, overall, the number of UTIs identified is relatively consistent throughout the surveillance period.

12. UTI Surveillance Descriptive Statistics
2014 – 2016 surveillance period
18 facilities participated
Urban, rural, and affiliates
2111 urine specimens + data collection form
1609 (76%) WITHOUT a urinary catheter
502 (24%) WITH a urinary catheter
C&S submission and UTI identified by month
Reasons for urine C&S

13. Explain the title
Explain x axis (right to left)
Explain Y axis (up and down)

14. 377/1140 = 33%

16. UTI Surveillance Contamination
Contamination reported for 2015 – 2016
835 urine specimens with forms
269 (32%) urine specimens contaminated
197 (73%) WITHOUT a urinary catheter
72 (27%) WITH a urinary catheter

17. UTI Surveillance Laboratory Costs
Costs for processing a urine C&S: $42.80
Surveillance period:
All urine specimens: $90,350.80
Symptomatic residents: $48,792.00
UTI identified: $16, (18% of overall cost)
All other reasons: $41,558.80
Contaminated (2015 – 2016): $11,513.20

18. UTI Surveillance Limitations
Passive surveillance
Not all 23 LTC sites participate
Labeling C&S lab reports
Data error: lab req & collection tool
Following “Golden Rule” of 80%
<80% No report is generated
≥80% Report is generated
Rural Lab reports- Currently reported as reference site. Lab working on changing system
Lab Requisitions
Golden Rule- Met with LTCF-rural, affiliates, WRC & RPV uptake was good? significant decline in LTCF/units meeting rule of 80% Will Provide a 6 month status update by facility for Rule of 80%

19. UTI Surveillance Future Strategies
Reduce limitations
Number of urine C&S submitted
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Education: ICP, CNE- MOH tool, specimen collection, contamination, cost
Abide by the 80%
Presentations to staff
Provide quarterly “80% rule” table
Labeling C&S Reports: Site not “REF”
Pilot Project on a unit
Address #1 (intervention): will the # of urine specimens, contamination, cost decrease?
Compare 6 month pre-intervention with 6 month post-intervention

20. Thank You