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A nurse clinician program improved pediatric bacteriuria (bacteria in urine) healthcare. Adequate therapy significantly reduced persistent bacteriuria, highlighting the program's effectiveness in managing urinary tract infections.
Area of Science:
- Pediatrics
- Infectious Diseases
- Healthcare Management
Background:
- Bacteriuria in children can lead to complications if not adequately treated.
- Monitoring healthcare delivery is crucial for effective management of pediatric infections.
Purpose of the Study:
- To describe a nurse clinician-led program for monitoring pediatric bacteriuria healthcare.
- To evaluate the impact of adequate healthcare on bacteriuria clearance in children.
Main Methods:
- Identified 152 children with significant bacteriuria (≥10(5) organisms/ml) from 351 patients.
- Assessed healthcare adequacy and bacteriuria clearance rates.
- Radiographic evaluation for urinary tract anomalies in recurrent cases.
Main Results:
- Adequate healthcare was provided to 76% of patients; inadequate healthcare to 24%.
- Inadequate therapy was associated with a significantly higher failure to clear bacteriuria (37% vs. 7%, p<0.001).
- Eight patients with recurrent bacteriuria despite adequate therapy showed no urinary tract anomalies.
Conclusions:
- Nurse clinician monitoring can improve healthcare delivery for pediatric bacteriuria.
- Recurrence of urinary tract infections (UTI) is a key indicator of therapy adequacy.
- The program demonstrated a unique approach to managing pediatric bacteriuria.
Abstract:
A program which used a nurse clinician to monitor the health care received by children with bacteriuria is described. We identified 152 patients with significant bacteriuria (greater than or equal to 10(5) organisms/ml) by urine culture from 351 patients who either had symptoms suggestive of urinary tract infections or routine urinalysis during health care visits. Adequate health care was provided to 116 (76%) of the 152 patients and inadequate health care to 31 (24%) of these patients. A significant number of patients who received inadequate therapy (12 of 36, or 37%) compared to 8 (7%) of 116 patients who received adequate therapy failed to clear their bacteriuria (Chi-square = 17, p less than 0.001). Eight patients with recurrent bacteriuria despite adequate therapy were shown to have no urinary tract anomaly by radiography. The use of recurrence of UTI as a criterion for measuring adequacy of therapy and the uniqueness of the program are discussed.