1. U & I Preventing UTIs Post-surgical Units at Surrey Memorial Hospital (Orthopedics and General Surgery)
Team Members:
Alana Cohen
Margaret Dyka
Dareena Malli
Pawan Sindhar
Brenda Smith
Lorraine Prysunka
Susann Camus
Filda Grado
Jas Sidhu
Melanie Skidmore
Leah Tennant
Angela Wilson
SQAN Presentation: November 16, 2012

2. Team Goal Apply National Surgical Quality Improvement
Program (NSQIP) data and methods to reduce
Urinary Tract Infection rates in SMH
Postsurgical Patients from 1.6% on
February 29, 2012 to 0.8% by June 30, 2012

3. Improvement Strategies
Use NSQIP risk and non-risk adjusted data to drive improvement
Apply NSQIP best practices

4. Quality Improvement Strategies Team Goals
Use Positive Deviance and TRIZ
Carry out Plan-Do-Study-Act (PDSA) cycles to test improvements and small changes
Staff and patient education
Regular facilitated meetings
Team meets q 2-3 weeks for mins to keep involved and up to date with education and improvements

5. What we have done to date
Developed Foley plan of care sticker for Kardexes
PDSA Cycles performed on positioning of catheter bag, integrity of loops, catheter care and documentation of Foley plan of care on Kardex
Chart reviews
Chart reviews completed on patients who have had an UTI to understand the path and see where improvements could have been made.

6. What we have done to date con’t
Pioneered use of physician reminder sticker
Staff huddles and contests
Posters, factoids and
spot checks
Patient education
Staff huddles performed, also had a contest on the units: Asked questions of which answers were given previously in huddles, all correct answers thrown in a draw and 5 winners awarded a Starbucks gift Certificate
Posters/Factoids posted in walls, staff room. Spot checks performed regularly to remind staff to look out for the best practices (ie. Catheter care performed, drainage containers rinsed/changed, catheter size appropriate, etc)
Education provided to patients to inform risks of catheter and promoting them to answer why they have catheters.

7. Results

8. Results

9. Lessons learned No quick fixes Important to master the basics
Essential to remind people and to ensure new staff and casual staff are included in education
Key challenge: getting the word out and getting people to change practice
Be persistent

10. Hints for new teams 6-8 staff members is optimal
Every team member is actively involved
Facilitated meetings keep us on track
Build in time during meetings to do PDSA cycles
Have fun
Celebrate successes
Meetings are fun (snacks, jokes, etc)

11. Wavin’ the Cath (apologies to K’naan)
When we get data, we will drill down
Call us high flyers
High flyers wearing the crown
Chorus:
Call us high flyers. High flyers wearing the crown.
We will cut back,
We will cut back.
First Verse:
From Surrey downtown, Surgical Floor
These are my patients, couldn’t ask fo’ more
This is our way, I am a nurse
Caring is first, knowledge we thirst
Our patients come first, they’ll be the best,
PDSA we always test
Patient will heal, this is for real
This is our way, that’s all we can say
Times struggling, Getting the word out
We’re wondering, what’s that about now
We actively wait for zero point eight
It’s not far away, For now we say
Chorus
Second Verse:
Two person insertion is less exertion,
Use the best practice, tell everyone
Hold all our contests, we’ve just begun
No easy way, Work is the way
Let’s do this together, make all believers
NSQIP best practice, strive to improve
We’re making our way to zero point eight
We’ll not give up, Our team is great!
We’re reminding, all the physicians
We’re stickering, all our Kardexes
We’ll actively wait for zero point eight
It’s not far away but for now we say.
Chorus (repeat twice)