A retrospective comparison of guidelines to assess hospital-diagnosed urinary tract infection in nursing home residents - 22/10/21
, Roxanne Buterakos, DNP, RN, PNP-BC, AG-ACNP-BC a, Laura M. Wagner, PhD, RN, GNP, FAAN b, Jenny Tith, BS c, Shoou-Yih D. Lee, MS, PhD dHighlights |
• | Appropriate treatment of UTI in hospitalized NH residents is low. |
• | The Cooper tool and Stone criteria have moderate levels of diagnostic agreement for UTI. |
• | Appropriate UTI treatments were seen more frequently with catheterized residents. |
• | Fever and change in mental or functional status were the most reported signs of UTI. |
• | Only 24% of treated UTIs had a documented culture and sensitivity. |
• | Use of UTI specific sign and symptom terminology may improve diagnostic accuracy. |
Résumé |
Background |
Inappropriate antibiotic treatments for urinary tract infection (UTI) in nursing home (NH) residents are common and contribute to antibiotic resistance. Published guidelines aim to improve accurate assessment, diagnosis, and treatment of UTIs. This study assessed whether records from hospitalized NH residents diagnosed with UTI, while comparing the Cooper Tool and Stone criteria, supported appropriate treatment.
Methods |
A retrospective chart review was conducted using electronic medical record (EMR) data from residents of 3 NHs who were diagnosed with UTI when hospitalized over a 3-year period. The Cooper Tool and Stone criteria were used to assess treatment appropriateness.
Results |
Of 79 hospitalized residents treated for UTI, 11 (13.9%) were appropriately treated according to the Cooper Tool and 9 (11.4%) according to Stone. The 2 criteria agreed in 9 of the cases including 100% of those with catheters. Urinalysis was documented in 72% of residents and 24% had documentation of culture and sensitivity.
Conclusions |
Appropriate UTI treatment rates using both tools were low but much higher in those with catheters. Future research is necessary to validate the use of these tools in the hospital setting which have the potential to improve treatment accuracy and reduce unnecessary antibiotics use.
Le texte complet de cet article est disponible en PDF.Key Words : UTI, Assessment, Long-term care, Hospitals
Plan
| Conflicts of interest: None to report. The authors wish to thank MCubed for cross-campus research collaboration |
Vol 49 - N° 11
P. 1354-1358 - novembre 2021 Retour au numéro
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