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‘Little consistency’ for UTI prevention in nursing homes

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There is little consistency across facilities of policies implemented to prevent urinary tract infections in nursing homes, research from the US has indicated.

Responses from 955 nursing homes with 88,135 residents were linked to infection data from public health services – Medicare and Medicaid – to identify policies and practices associated with lower UTI prevalence.

“There were more UTIs that were not associated with catheterisation than those that were”

Carolyn Herzig

According to the study, 5.4% – or more than 4,700 nursing home residents – experienced a UTI every month.

If a resident had a catheter, they were four times more likely to get a UTI than if they did not have a catheter at all. But more infections were not associated with catheter use than those that were.

The study was led by Patricia Stone, from the Center for Health Policy at Columbia University School of Nursing.

Fellow author Carolyn Herzig, a project director at the nursing school, said: “UTIs are the most common infection in nursing homes, and we wanted to determine what policies and procedures would help these facilities lower UTI prevalence.

“What was particularly interesting about this study was that there were more UTIs that were not associated with catheterisation than those that were,” she said.

“This means that a larger focus should be placed on identifying practices to prevent UTIs regardless of catheter placement,” she added.

The study examined nine UTI prevention policies and found the following policies were associated with lower infection prevalence:

It found nursing homes that had a policy for using portable bladder ultrasound scanners to determine if all of the urine was being voided were 10% less likely to have high rates of UTIs that were not associated with catheter use. However, only 22% of surveyed facilities had this policy.

Homes that had a policy in place for cleaning the urine collection bag attached to the resident’s leg were 20% less likely to have high rates of catheter-associated UTIs. Yet only 44% of surveyed facilities had this policy in place.

Meanwhile, those with infection prevention staff who took a national course were 20% less likely to have high rates of UTIs.

The study was presented at the annual conference of the Association for Professionals in Infection Control and Epidemiology in Charlotte, North Carolina.

APIC president Susan Dolan, a nurse and hospital epidemiologist at the Children’s Hospital Colorado, warned that infection prevention in long-term care was going to “become an increasingly important issue” because of aging populations.

“Recognising the severity of UTIs for older adults, and implementing policies in nursing homes and long-term care facilities to prevent and effectively treat these infections, is critical,” she said.

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