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Reducing Inappropriate Antibiotics for Urinary Tract Infections in Long-Term Care: A Replication Study
Denise Cooper1, Marilyn McFarland, Francesca Petrilli
1School of Nursing, University of Michigan-Flint (Drs Cooper and McFarland); Impact Physician Group, Pontiac, Michigan (Dr Petrilli); and Michigan Health Specialists, Flint (Dr Shells).
Journal of Nursing Care Quality
|June 19, 2018
Summary
Implementing the Cooper Urinary Tract Infection Program in nursing homes significantly improved nurse knowledge and reduced unnecessary antibiotic use for urinary tract infections, decreasing adverse drug events and resistance.
Area of Science:
- Geriatric Medicine
- Infectious Disease Management
- Healthcare Quality Improvement
Background:
- Nursing home providers frequently face challenges in accurately assessing and treating urinary tract infections (UTIs).
- Over-prescription of antibiotics for asymptomatic bacteriuria is common, leading to adverse drug reactions, antimicrobial resistance, and C. difficile infections.
- There is a critical need for evidence-based interventions to optimize UTI management in long-term care settings.
Purpose of the Study:
- To replicate the established Cooper Urinary Tract Infection Program in a new long-term care facility.
- To evaluate the effectiveness of the Cooper Urinary Tract Infection Program in reducing inappropriate antibiotic use and improving patient outcomes.
Main Methods:
- A pre-post study design was employed at a 120-bed Midwest long-term care and rehabilitation facility.
- The multifaceted Cooper Urinary Tract Infection Program was implemented, incorporating a decision-support tool (Cooper tool algorithm), provider education, and designated change champions.
- Data collection focused on nurse knowledge, UTI rates, antibiotic prescribing patterns, and urinalysis utilization.
Main Results:
- Significant improvements were observed in nursing staff knowledge regarding UTI assessment and management.
- A notable reduction in the incidence of urinary tract infections was achieved.
- Inappropriate antibiotic treatments and the frequency of urinalysis testing were significantly decreased post-implementation.
Conclusions:
- The findings support the efficacy of the Cooper Urinary Tract Infection Program in reducing inappropriate antibiotic usage for UTIs in long-term care facilities.
- Successful replication of the program demonstrates its generalizability and potential for widespread adoption.
- Implementing this program contributes to antimicrobial stewardship efforts and enhances patient safety in geriatric populations.
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