Implementation of a Suspected Urinary Tract Infection Decision Support Tool to Improve Antibiotic Stewardship in a Long-Term Care Facility

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Teresa M. Synowiez (Creator)
The University of North Carolina at Greensboro (UNCG )
Web Site:
Angela Kabbe

Abstract: Background: Inappropriate antibiotic use in long-term care (LTC) facilities contributes to antibiotic resistances which impact mortality, care, and healthcare costs. Antibiotic stewardship seeks to optimize infection treatment and reduce adverse events associated with antibiotic use. Asymptomatic bacteriuria occurs in 15-50% of LTC residents. Nontreatment of asymptomatic bacteriuria (ASB) is a sustainable strategy for reducing inappropriate antibiotic utilization. Purpose: The purpose of this quality improvement (QI) project was to implement a decision support tool (DST) and evaluate its effectiveness in promoting antibiotic stewardship in a LTC facility. The project’s goal was to decrease inappropriate treatment of ASB using the suspected urinary tract infection (UTI) DST. Methods: A quasi-experimental quantitative design was used to provide education and implement the suspected UTI DST to support antibiotic prescribing and promote best practice guidelines at a 100-bed LTC facility in the southeastern United States. The convenience sample included 68 adults with median age 84. Results: Statistical analysis revealed a 66.67% decrease in urinalysis orders and modest decrease in antibiotic rates for suspected UTI after implementation of the suspected UTI DST. The suspected UTI DST improved antibiotic stewardship by decreasing urinalysis rates and decreasing unnecessary antibiotic use. Reduction in urinalyses performed decreased treatment of ASB. Recommendations and Conclusions: Longitudinal data is needed to validate these results. Continued use of the suspected UTI DST at LTC facilities has the potential to yield long-term improvements in antibiotic stewardship while concurrently improving healthcare quality and healthcare costs.

Additional Information

Language: English
Date: 2022
long-term care, antibiotic resistances, antibiotic stewardship, urinary tract infection

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