Manage patients effectively, make appropriate use of resources 

PrimaryCare IT has been working hard on a new integrated pathway within EMIS Web for patients with suspected urinary tract infection. This means that every time a patient is coded as having a suspected or confirmed urinary tract infection, they are checked against our internal concepts. In this way, we ascertain the following details about the patient:

  • Male or femaleshutterstock 280364663
  • Age
  • Pregnant
  • Catheterised
  • Has impaired renal function
  • Has recurrent UTIs
  • Has abnormal urinary tract (for example renal calculus, vesicoureteric reflux, reflux nephropathy, neurogenic bladder, urinary obstruction, or recent instrumentation) 
  • Is immunosuppressed,

We then collect some information using our the OneTemplate which contains tailored information for the patient depending on where they sit in relation to the above questions.  In this way we are able to guide clinicians in their use of dipsticks, pathology requests and also in their subsequent choice of treatment - with our protocol taking into account national antibiotic prescribing guidelines.  All of this is in line with the following guidelines

  • CKS
  • British Infection Association
  • HPA

The information is tailored for the type of user with doctors receiving different prompts to nurses, to HCAs, all of which can be adapted to the way your practice organises itself. We have integrated self care pathways for patients within the system which you can utilise within your practice to allow remote management of simple uncomplicated urinary tract infections.

Why focus on UTIs?

The unnecessary use of tests and antibiotic treatment may be minimised by developing simple decision rules, diagnostic guidelines or other educational interventions. Prudent antibiotic prescribing is a key component of the UK's action plans for reducing antimicrobial resistance. Unnecessary antibiotic treatment of asymptomatic bacteriuria is associated with significantly increased risk of clinical adverse events, including Clostridium difficile or methicillin‑resistant Staphylococcus aureus infections, infection with multi‑drug‑resistant gram‑negative organisms including extended‑spectrum beta‑lactamase organisms and carbapenem‑resistant Enterobacteriaceae, and the development of antibiotic‑resistant urinary tract infections.  Our pathways ensure compliance with all 7 NICE quality standards. 

What will this mean for my practice?

We will work with you to understand how your practice manages patients currently and make sure that our pathways integrate smoothly and cause minimal interruption whilst ensuring that prompts remind users of the nationally agreed guidelines for management. Through extensive testing we are confident our standard protocols represent a good balance, but we are able to adapt for individual practices needs. Patients that are suitable can be managed without the need to be seen, reducing the need for clinical appointment availability within your practice.  We will sign a confidentiality agreement with your practice and then install the protocols on your system. Initial anonymised data searches will be undertaken to allow us to judge the effectiveness of the project and feedback will be given to practices on patients they have who may have undiagnosed hypertension.

Any concerns?

Contact our team to discuss: queries@primarycareit.co.uk