IMPLEMENTING A NURSE-LED URINARY TRACT INFECTION ALGORITHM IN LONG-TERM CARE

Date
2020
Authors
Dizon, Kristia
Contributor
Advisor
Ceria-Ulep, Clementina
Department
Nursing Practice
Instructor
Depositor
Speaker
Researcher
Consultant
Interviewer
Annotator
Journal Title
Journal ISSN
Volume Title
Publisher
Volume
Number/Issue
Starting Page
Ending Page
Alternative Title
Abstract
Background: Long-term care facilities are high-risk settings for the passage of antibiotic-resistant infections between residents living in a shared space. It is especially important to assess for infections accurately and prescribe antibiotics only when indicated in order to combat the growing problem of antibiotic resistance in the United States. Purpose and Objectives: This evidence-based quality improvement project implemented a two-fold intervention in a long-term care setting in Honolulu, Hawaii. Providing education and an algorithm were used to streamline and focus nursing assessments according to published guidelines. The goal was to improve nursing assessment of suspected urinary tract infections (UTI) and decrease orders for urinalysis, a common diagnostic tool to test for bacteria in urine. Methods: A total of 20 registered nurses (RNs) and 10 certified nursing assistants participated in the educational training sessions. Likert-scale surveys were administered to RNs after each educational training session and at midpoint of the implementation period in order to assess effectiveness of the training. Urinalysis orders were monitored as a measure of assessing effectiveness and use of the algorithm by nurses. Results: It was found that there was a 31.5% decrease in orders for urinalysis between the pre- and post-implementation periods. While the UTI algorithm was not used by RNs, the education provided by the DNP student may have contributed to the positive change. Conclusion: Sustainability of the UTI algorithm was poor due to the difficulty in incorporating more tasks and assessments for an already-busy nursing routine. However, the Likert-scale surveys showed positive results regarding benefits of the educational training sessions. This project shows promise for relying on the large nursing workforce in order to influence the type and course of treatment for suspected infections.
Description
Keywords
Nursing, antibiotic stewardship, elderly, long-term care, urinary tract infections
Citation
Extent
58 pages
Format
Geographic Location
Time Period
Related To
Table of Contents
Rights
All UHM dissertations and theses are protected by copyright. They may be viewed from this source for any purpose, but reproduction or distribution in any format is prohibited without written permission from the copyright owner.
Rights Holder
Local Contexts
Email libraryada-l@lists.hawaii.edu if you need this content in ADA-compliant format.