Failure to Accurately Apply McGeer Criteria in Antibiotic Stewardship Program
Penalty
Summary
The facility failed to properly implement its antibiotic stewardship program as required by its own policies and procedures. Specifically, the facility did not ensure that the McGeer criteria, which are used to determine true infections in long-term care settings, were accurately completed for a resident. Medical record review showed that only one of the required criteria for urinary tract infection (UTI) surveillance was fulfilled, yet the checklist indicated that the UTI criteria were met. Despite this, a physician's order was written to administer cephalexin for a UTI. The Director of Staff Development/Infection Preventionist (DSD/IP) confirmed that two criteria must be met for the McGeer criteria for UTI, but acknowledged that only one was checked and that she had forgotten to check the second box, even though she believed it was fulfilled. Interviews with both the DSD/IP and the Director of Nursing (DON) confirmed the findings that the McGeer criteria were not accurately documented or followed. The DSD/IP stated that her determination of a true infection was based on the boxes checked on the surveillance checklist, which in this case was incomplete. This failure to accurately apply and document the McGeer criteria had the potential to result in inappropriate antibiotic use and misidentification of true infections.