Phlebotomy and Rapid Diagnostic Service (RDS)
Infection Prevention & Control / Patient Safety
06.2021
Phlebotomy: 100% compliance RDS: 90% compliance to 100% with measures to address areas of concern
Implementation and validation of standards maintained and checked with daily IP&C checks Outcome: 100% compliance achieved by end 07.2021
To provide NNPC with a framework with which to manage and monitor the practice for infection control purposes and CQC compliance (Regulation 15 re: premises, as well as the registration requirement that practices are charged with "assessing the risk of, and preventing, detecting and controlling the spread of, infections, including those that are health care associated").
Child Safeguarding audit: Who is accompanying the child and clear documentation of who has given consent UTI Audit – ECHT clinician
Safeguarding To ensure compliance with standards set in the NNPC Policies - consent, safeguarding children, and phlebotomy & blood
06.2021
57% overall compliance against expected standards.
Education and training implemented to address areas of education and learning for staff. Recommended to re- audit in 6-8 weeks after training is put into place Outcome: Achieved 100% compliance in 08.2021 The first recommendation is for the clinicians to be reminded or the PHE (2020) guidelines for diagnosis and prescribing of UTIs in the over 65s. This recommendation would also involve clinicians ensuring they keep up to date with own learning and changes to guidance. The second recommendation is ongoing support and clinical supervision with ACP and NP clinicians specifically including telephone assessment. A third recommendation is ongoing training in leadership and improvement of services which in turn will help to support change of routine and habits within healthcare clinicians but also with care home staff. The lead clinician from each PCN involved in the audit will engage with care home staff to identify their current knowledge and what learning needs they may have regarding UTI management and diagnosis. The fourth recommendation is for continued training and support in the use of available IT tools such as templates and formulary guidance to allow for prompts, appropriate documentation and prescribing. Outcome: Audit results were distributed to Practices, learning needs identified, supervision and education to be implemented, and engagement with care homes about UTI management was undertaken. The staff member who carried out this audit left NNPC employment before a re-audit was undertaken.
handling. To highlight any areas of learning required by the clinical staff
Service improvement, Quality Assurance & Patient Safety
A service improvement audit will be undertaken as part of the clinicians MSc studies. The aim is to identify a specific area in the assessment / treatment of UTI and carry out the audit – medicines management. Title: ‘ A clinical audit to evaluate the compliance of using Public Health England: Diagnosis of urinary tract infections in diagnosing and prescribing for urinary tract infections in the over 65s’ Objective 1: To ensure diagnosis of UTIs in over 65s is accurate, evidence based and safe Objective 2: To ensure any prescriptions for treatment of UTIs in over 65s is in line with current guidance and formulary
Commenced 03.2021 Completed 06.2021
Overall compliance for objectives 1 & 2 diagnosis was 36%- not meeting the target of 100% Overall compliance for objectives 1 & 2 prescribing was 48% - not meeting the target of 100% The 25 consultations audited consisted of 12 GP, 10 Nurse practitioner (NP) and 3 Advanced clinical practitioner (ACP) consultations, with 19 of those being telephone based and 6 being face to face. All the 6 face to face consultations were carried out by NPs or ACPs which during this time were part of the care home visiting team supporting the surgeries throughout the pandemic. 21 of the consultations audited were female and 4 males, this equates to 84% and 16% respectively. 12 out of 25 (48%) consultations used a urine dipstick to aid in diagnosis. In 2 out of the 6 (33.3%) face to face consultations a urine dipstick was used compared to 10 out of 19 (52.6%) via telephone. In those prescribed antibiotics 16 out of 25 (64%) had an MSU sent. Of which 7 of these (43.7%) returned negative for infection, 4 out of these 7 (57.1%) consultations used a urine dipstick to aid their diagnosis. 43.7% of these patients received inappropriate antibiotics.
NNPC Quality Account 2021/22
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