Policy Manual sample

MDT Home Health Care Agency, Inc. and the criteria for each of the specific types of infection follow it. UTI - URINARY TRACT INFECTION SUTI-Symptomatic urinary tract infection A symptomatic urinary tract infection must meet at least 1 of the following criteria: 1. Patient has at least 1 of the following signs or symptoms with no other recognized cause: fever (>38 o C), urgency, frequency, dysuria, or suprapubic tenderness and patient has a positive urine culture, that is, >10 5 microorganisms per cc of urine with no more than 2 species of microorganisms. 2. Patient has at least 2 of the following signs or symptoms with no other recognized cause: fever (>38 o C), urgency, frequency, dysuria, or suprapubic tenderness and at least 1 of the following a. positive dipstick for leukocyte esterase and/or nitrate b. pyuria (urine specimen with >10 white blood cell [WBC]/mm3 or >3 WBC/highpower field of unspun urine) c. organisms seen on Gram’s stain of unspun urine d. at least 2 urine cultures with repeated isolation of the same uropathogen (gramnegative bacteria or Staphylococcus saprophyticus) with >10 2 colonies/mL in nonvoided specimens e. <10 5 colonies/mL of a single uropathogen (gram-negative bacteria or S saprophyticus) in a patient being treated with an effective antimicrobial agent for a urinary tract infection f. physician diagnosis of a urinary tract infection g. physician institutes appropriate therapy for a urinary tract infection. 3. Patient #1 year of age has at least 1 of the following signs or symptoms with no other recognized cause: fever (>38 o C rectal), hypothermia (<37 o C rectal), apnea, bradycardia, dysuria, lethargy, or vomiting and patient has a positive urine culture, that is, >10 5 microorganisms per cc of urine with no more than two species of microorganisms. 4. Patient #1 year of age has at least 1 of the following signs or symptoms with no other recognized cause: fever (>38 o C), hypothermia (<37 o C), apnea, bradycardia, dysuria, lethargy, or vomiting ASB-Asymptomatic bacteriuria An asymptomatic bacteriuria must meet at least 1 of the following criteria: 1. Patient has had an indwelling urinary catheter within 7 days before the culture and patient has a positive urine culture, that is, >10 5 microorganisms per cc of urine with no more than 2 species of microorganisms and patient has no fever (>38 o C), urgency, frequency, dysuria, or suprapubic tenderness. 2. Patient has not had an indwelling urinary catheter within 7 days before the first positive culture and patient has had at least 2 positive urine cultures, that is, >10 5 microorganisms per cc of urine with repeated isolation of the same microorganism and no more than 2 species of microorganisms and patient has no fever (>38 o C), urgency, frequency, dysuria, or suprapubic tenderness. OUTI-Other infections of the urinary tract (kidney, ureter, bladder, urethra, or tissue surrounding the retroperitoneal or perinephric space) Other infections of the urinary tract must meet at least 1 of the following criteria: 1 Patient has organisms isolated from culture of fluid (other than urine) or tissue from affected site. 2 Patient has an abscess or other evidence of infection seen on direct examination, during a surgical operation, or during a histopathologic examination. Home Health Agency Nursing Care & Procedures K-139