Reducing Inappropriate Antibiotics for Urinary Tract Infections in Long-Term Care: A Replication Study

J Nurs Care Qual. 2019 Jan/Mar;34(1):16-21. doi: 10.1097/NCQ.0000000000000343.

Abstract

Background: Nursing home providers face challenges in urinary tract infection assessment and treatment, often prescribing unnecessary antibiotics for asymptomatic bacteriuria, a practice that can result in adverse drug reactions, drug resistance, and an increase in antibiotic-associated diarrhea.

Purpose: The purpose of this project was to replicate the Cooper Urinary Tract Infection Program in another facility and measure its effectiveness.

Methods: Using a pre-post design, this project was implemented at a 120-bed, long-term care and rehabilitation facility located in the Midwest United States.

Interventions: This project used the multifaceted Cooper Urinary Tract Infection Program that includes the Cooper tool algorithm, didactic education for providers, and change champions.

Results: The results were significant improvements in nurse knowledge and reduced rates of urinary tract infections, inappropriate antibiotic treatments, and urinalyses.

Conclusions: These results add to the evidence for implementing the Cooper Urinary Tract Infection Program in long-term care facilities for effective reduction of inappropriate antibiotic usage for urinary tract infection.

MeSH terms

  • Aged, 80 and over
  • Algorithms
  • Anti-Bacterial Agents / therapeutic use*
  • Female
  • Health Personnel / education
  • Humans
  • Inappropriate Prescribing / adverse effects*
  • Long-Term Care*
  • Male
  • Midwestern United States
  • Nursing Homes
  • Organizational Innovation*
  • Urinary Tract Infections / prevention & control*

Substances

  • Anti-Bacterial Agents