Can multiple sclerosis nurses help reduce non-elective admissions? An analysis of a service delivery audit

Background: It has been identified that nearly one-in-five people with multiple sclerosis (MS) have been admitted to hospital as a non-elective admission in 2018–2019. The average national stay is 7.7 days, at an average cost of £2844. Emergency hospital admissions for people with multiple sclerosis are rising nationally. Method: The authors conducted a 12-month audit of non-elective admissions across two clinical sites, comparing and contrasting the data gathered with national Hospital Episode Statistics. The outcome of the data collection influenced changes in local service delivery. Findings: The most common reasons identified for non-elective admissions related to MS were associated with respiratory issues (4255 admissions), with the most common single cause being urinary tract infections (2960 admissions). Bladder and bowel issues combined also accounted for 3550 admissions in 2018/19. Conclusion: The data identified urinary tract infections and sepsis as the largest presentation of non-elective MS admissions to both trusts. Certain recommendations have been made that will contribute to the improvement of service delivery and better quality care.

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Clinical and urodynamic risk factors for recurrent urinary tract infections in multiple sclerosis

10.26226/morressier.5b7578605aff7400151f3140 ◽

2018 ◽

Author(s):

paloma Montero ◽

Vanesa Pytel

Keyword(s):

Risk Factors ◽

Multiple Sclerosis ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Recurrent Urinary Tract Infections ◽

Tract Infections

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Infeções do Trato Urinário numa Coorte de Transplantados Renais

Acta Médica Portuguesa ◽

10.20344/amp.4959 ◽

2014 ◽

Vol 27 (3) ◽

pp. 364 ◽

Cited By ~ 2

Author(s):

Ana Bispo ◽

Milene Fernandes ◽

Cristina Toscano ◽

Teresa Marques ◽

Domingos Machado ◽

...

Keyword(s):

Risk Factors ◽

Escherichia Coli ◽

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Urinary Tract Infections ◽

Hospital Admissions ◽

Female Gender ◽

Tract Infections

Introduction: Urinary tract infection is the most common infectious complication following renal transplantation and its frequency is insufficiently studied in Portugal. The aim of this study was to characterize the incidence of urinary tract infections and recurrent urinary tract infections in renal transplant recipients. Material and Methods: This was a retrospective cohort observational study, obtained from clinical files of all patients who received a renal transplant at the Hospital of Santa Cruz, from January 2004 to December 2005, with a mean follow-up period of five years or until date of graft loss, death or loss of follow-up. After a descriptive analysis of the population, we used bivariate tests to identify risk factors for urinary tract infections. Results: A total of 127 patients were included, with a 593 patients.year follow-up. We detected 53 patients (41.7%) presenting with at least one episode of urinary tract infection; 21 patients (16.5%) had recurrent urinary tract infection. Female gender was the only risk factor associated with the occurrence of urinary tract infections (p < 0.001, OR = 7.08, RR = 2.95) and recurrent urinary tract infections (p < 0.001, OR = 4.66, RR = 2.83). Escherichia coli (51.6%), Klebsiella pneumoniae (15.5%) and Enterobacter spp (9.9%) were the most frequently identified pathogens. Patients did not reveal an increased mortality or allograft loss. However, urinary tract infections were the most important cause of hospital admissions. Discussion: Female gender was the only risk factor for urinary tract infections in this population. Escherichia coli was the most frequent agent isolated. Conclusion: Despite preventive measures, urinary tract infections remain an important cause of morbidity and hospital admissions. Keywords: Urinary Tract Infections; Postoperative Complications; Risk Factors; Kidney Transplantation; Portugal.

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Reducing urinary tract infections in care homes by improving hydration

BMJ Open Quality ◽

10.1136/bmjoq-2018-000563 ◽

2019 ◽

Vol 8 (3) ◽

pp. e000563 ◽

Cited By ~ 4

Author(s):

Katie Lean ◽

Rasanat Fatima Nawaz ◽

Sundus Jawad ◽

Charles Vincent

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Hospital Admissions ◽

Low Cost ◽

Care Home ◽

Kidney Injury ◽

Care Staff ◽

Care Homes ◽

Raising Awareness ◽

Tract Infections

Dehydration may increase the risk of urinary tract infections (UTIs), which can lead to confusion, falls, acute kidney injury and hospital admission. We aimed to reduce the number of UTIs in care home residents which require admission to hospital. The principal intervention was the introduction of seven structured drink rounds every day accompanied by staff training and raising awareness. UTIs requiring antibiotics reduced by 58% and UTIs requiring hospital admissions reduced by 36%, when averaged across the four care homes. Care home residents benefited from greater fluid intake, which in turn may have reduced infection. Structured drink rounds were a low-cost intervention for preventing UTIs and implemented easily by care staff.

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