1. Upon examination of the data sets, Marilyn Nelson and her colleagues identified several areas where the analysis revealed situations that were probably contributing to the clinic's high UTI rate. Look at the UTI rate for children whose parents had collected the specimen versus the rate for children who had been catheterized by nursing personnel to collect the specimen. What might be the reason for the higher rate in children whose parents had collected the specimen?
2. Are there any other areas in the data that reveal important aspects that may be contributing to the high UTI rates? What might be the reasons for these higher rates?
3. Upon discussion of the findings and examination of the flowcharted processes, the laboratory manager noted a subtle change in clinic processes that probably was contributing to the problem. House staff had begun at some point to Multistix the specimens in the original collection containers. Thus, what had been a clean-catch specimen could become a contaminated one when staff opened the container to perform the Multistix. What really should have been done was to pour off a small amount or aliquot of the specimen into another container, reseal the original container for the laboratory, and perform the Multistix on the aliquot container. This process would minimize the possibility of contaminating the original specimen. How would this change in process be represented in the flow charts presented in the case study?