[Improvement in the clinical management of urinary infections in a health centre by means of a quality management cycle. Analysis using lot quality assurance sampling].
OBJECTIVE
To improve clinical effectiveness of the management of urinary tract infections in a primary care centre by means of a Management Quality Cycle.


METHODS
Pre-post test.


METHODS
Urban primary care centre.


METHODS
We selected a clinical practice guideline for management of urinary tract infection by way of consensus among doctors, and using the evaluation document AGREE. The main points of the protocol chosen, and evaluation indicators were: the prescription of treatment with a single dose of 3 grams of fosfomycin orally without performing a urine strip or urine culture to those patients who met the protocol inclusion criteria. The results of these baseline indicators, as well as evaluation at six months after the intervention started, were reported and discussed with the doctors of medical centre. The measurement was conducted by audit of medical records selected by lot quality assurance sampling (LQAS).


RESULTS
Starting from a level of compliance of the indicators of, at best 52%, at 18 months after the intervention all major indicators had reached an acceptable quality level of 90% (5% alpha and beta 10%).


CONCLUSIONS
The introduction of a Management Quality Cycle for management urinary tract infections in our area, appears to modify the behaviour of health professionals and improve the clinical effectiveness.
Tormo Molina
J
J
Centro de Salud Salvador Caballero, Distrito Sanitario Granada, Servicio Andaluz de Salud, España. juantormomolina@telefonica.net
Santos García
M J
MJ
Hortal Carmona
J
J
Aguilar Cruz
I
I
Padilla Ruiz
F
F
Bueno Cavanillas
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D055810:Lot Quality Assurance Sampling; D008332:Management Quality Circles; D008875:Middle Aged; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000188:drug therapy*; D055815:Young Adult