foley related UTI

tkreilingtkreiling
in CDI Talk Archive
I was wondering if any of you have established a way to work with infection control regarding foley cath related UTI's. We have been getting some questions regarding the coding of some of our foley related UTI's from our infection control dept so now I am at the point I am not sure whether or not to be querying for them. Previously I would query if I saw a patient developed a UTI during hospital stay and the patient had a foley to see if the physician believes the two are related. According to our infection control nurses there is specific criteria for a UTI to be considered related to foley catheter related. How do others handle this situation? Do you use the CDC criteria before querying? Any suggestions or help would be appreciated. Thanks.

Comments

  • fentona@bronsonhg.orgfentona@bronsonhg.org
    edited May 2016
    We had this same issue. Two years ago we had this as a joint goal for CDS and our infection control nurses. If we came across what looked like a Foley related UTI on admit or while hospitalized, we emailed our IC nurses and they reviewed the chart for their specific criteria. At that time they emailed us back and let us know their thoughts. They were great about discussing finding w/ physicians, and if they could not, we follow up. It worked out great and all of us learned a lot. They also emailed us a tracking sheet monthly for all HAC conditions and any questions they had.
    Hope this helps,
    Amy


  • heidi.koenigheidi.koenig
    edited May 2016
    My IC nurse said any UTI within 48 hours of admission is considered POA. I will query after that if I think there are any questions. Our facility is currently on a big push to cut down on HAC. So any ambiguous charting by providers will be queried. For example...lady had fx radius, not mentioned anywhere in H&P or preop. Came in for hip replacement and had a wrist xray done in OR that showed fx. So I queried for POA(which it was).

    Thank you,
    Heidi Koenig, RN
    Clinical Document Specialist
    Ocala Regional Medical Center
    Heidi.koenig@hcahealthcare.com
    352-401-1686


  • mark.domineseymark.dominesey
    edited May 2016
    The IP world makes many different assumptions than the assumptions we make as Clin Doc Specs. These assumptions are primarily for statistical and reporting purposes and may not be the same assumptions we accept or even assumptions that physicians accept. Take an infection of an implanted device or joint; how many surgeons know that they "own" any infection of that operative site or device for one year from implantation? The statement that UTIs discovered within 48 hours are considered to be present on admission does apply to the IP world and we could likely make that case that it should apply to the Doc Spec world as well. But without clear documentation, it is always best to query the physician and get documented it in the medical record.

    I spent some time as an Infection Preventionist and attended an APIC Infection Control 101 course. It was great training but I still find myself undoing the assumptions I learned 2 years ago.

    Kindest Regards,

    Mark


    Mark Dominesey, RN/BSN, MBA
    Clinical Documentation Improvement Specialist
    Health Information Management Services
    Martha Jefferson Hospital
    459 Locust Ave
    Charlottesville, VA 22902
    Mark.Dominesey@mjh.org





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