Ask the Care Expert about ... urinary tract infections
Sherrie Dornberger, RNC, CDONA, FACDONA, executive director, NADONA
I hear there is a change with urinary tract infections and that there needs to be a bunch of criteria now before we can say someone has a UTI. Is this true?
This is true to a certain extent. In the past, many facilities documented a resident as having a urinary tract infection if she or he had burning on urination, a bit of confusion, a temperature of 100 degrees or blood in the urine. Any of these allowed some to diagnose a urinary tract infection.
If you have an antibiotic stewardship or infection prevention committee, both of them should be reviewing and changing policies to meet the new requirement. It states that more than one of the symptoms must be presented to determine a UTI.
The requirement now says the symptoms of a UTI, with lab results showing greater growth than 100,000 of an organism, tell diagnosis of a UTI by the physician or a nurse practitioner and the medication with the diagnosis. For instance, the medication could say, “Cipro 500 mg twice a day for 10 days” for a culture result of over 100,000 of E.coli with noted sensitivity.
This diagnosis also would be added to the MDS and care plan according to the facility's policies.
Remember, it is always required to follow the policies and procedures of your community or corporation. Don't go out on a limb and create policies on your own.
Your facility should have groups such as a pharmacy and therapeutics committee, infection prevention committee or antibiotic stewardship committee to develop these policies.
If you need a policy or need to review a policy per a change in regulation, bring it to the group's attention to get some guidance to provide the best possible care.