Interdisciplinary Pathway for Managing Urinary Tract Infections in Long-Term Care Facilities: A Practice Improvement Project

Abstract

Background: Urinary tract infections (UTIs) are one of the most common infections within residents of long-term care facilities. Antibiotics are commonly prescribed for patients in this setting without proper diagnostic criteria. For these reasons, proper diagnosis of UTIs should be a priority in order to decrease the antibiotic prescribing rates and untimely improve patient health outcomes. This practice improvement project was aimed at training interdisciplinary staff on evidence-based UTI surveillance and implementing a toolkit within a 148-bed long-term care facility to evaluate the effect on documented UTIs and antibiotic prescribing rates. Methods: This project was implemented in a 148-bed, long-term care facility in rural Northwest Alabama. A pre-post intervention was conducted to evaluate the education provided to interdisciplinary staff. The staff utilized a UTI toolkit and pre-post data concerning UTI rates and antibiotic prescribing rates was compared to determine the effectiveness of the UTI toolkit at reducing both UTI occurrence rates and overall antibiotic prescribing rates. Results: Using a pre-post questionnaire and a paired sample t-test, a comparison of the questionnaire results was made. Post-test scores were improved compared to pre-test scores. A comparison of the pre-intervention facility UTI rates and all-cause antibiotic prescribing rates versus postintervention rates was compared using McNemar’s Test. UTI rates and overall antibiotic prescribing rates were reduced in the post-intervention phase compared to the pre-intervention phase of the practice improvement project. Conclusion: This project improved assessment training for healthcare staff concerning UTI surveillance and reduced documented UTI rates and all-cause antibiotic prescribing rates.