KUKU

KU ScholarWorks

  • myKU
  • Email
  • Enroll & Pay
  • KU Directory
    • Login
    View Item 
    •   KU ScholarWorks
    • Dissertations and Theses
    • Dissertations
    • View Item
    •   KU ScholarWorks
    • Dissertations and Theses
    • Dissertations
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    IMPROVING THE MANAGEMENT OF ASYMPTOMATIC BACTERIURIA IN OLDER ADULTS IN LONG-TERM CARE

    Thumbnail
    View/Open
    Pattison_ku_0099D_16115_DATA_1.pdf (3.333Mb)
    Issue Date
    2018-08-31
    Author
    Pattison, Sally
    Publisher
    University of Kansas
    Format
    57 pages
    Type
    Dissertation
    Degree Level
    D.N.P.
    Discipline
    Nursing
    Rights
    Copyright held by the author.
    Metadata
    Show full item record
    Abstract
    Abstract Problem: The unnecessary or inappropriate use of prescription antibiotics is a public health problem. An estimated 40% to 75% of antibiotics prescribed in U.S. nursing homes may be unwarranted, and moreover, the most commonly treated infection in nursing homes is a urinary tract infection (UTI). Up to one-third to one-half of prescriptions used to treat suspected UTIs in nursing home residents are actually aimed at asymptomatic bacteriuria (ASB). Consistent findings show the treatment of ASB is unnecessary and can be harmful, leading to increased rates of Clostridium difficile, multidrug resistant organisms, adverse drug events, hospital admissions, and higher health care costs. The Centers for Disease Control and Prevention (CDC) recommends that all nursing homes take steps to improve antibiotic prescribing practices through the utilization of antibiotic stewardship activities. The CDC defines antibiotic stewardship as a set of commitments and actions designed optimize the treatment of infections while reducing adverse events associated with antibiotic use. Project Aim: The purpose of this quality improvement project was to assess if the implementation of an antibiotic stewardship program in the nursing home setting decreases the rate of antibiotics prescribed for ASB in older adults. Project Method: A retrospective chart review of data was utilized to record baseline rates of antibiotics prescribed for UTIs and ASB. The chart review included the analysis of nursing notes, progress notes, provider visits, and nursing home infection logs to determine if an antibiotic was prescribed for a symptomatic UTI versus ASB. An antibiotic stewardship program consisting of an educational session about antibiotic stewardship and a decision-making tool was implemented and utilized by nurses and providers. Recommendations regarding antibiotic prescribing practices for suspected UTIs and a toolkit for suspected UTIs developed by the Agency for Healthcare Research and Quality served as core elements of the antibiotic stewardship program. The rate of antibiotics prescribed for UTIs and ASB was evaluated and compared to baseline data at two months. Project Results: Baseline data revealed that 64% of antibiotic prescriptions written for suspected UTIs were aimed at ASB. Exposure to the antibiotic stewardship program decreased the rate of antibiotic prescriptions written for ASB by 18%, as the rate of antibiotics written for ASB in the post intervention period was 46%. Conclusion: The antibiotic stewardship program and decision-making tool decreased the rate of antibiotics prescribed for ASB in older adults in the long-term care setting.
    URI
    http://hdl.handle.net/1808/27964
    Collections
    • Dissertations [4474]
    • KU Med Center Dissertations and Theses [464]

    Items in KU ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.


    We want to hear from you! Please share your stories about how Open Access to this item benefits YOU.


    Contact KU ScholarWorks
    785-864-8983
    KU Libraries
    1425 Jayhawk Blvd
    Lawrence, KS 66045
    785-864-8983

    KU Libraries
    1425 Jayhawk Blvd
    Lawrence, KS 66045
    Image Credits
     

     

    Browse

    All of KU ScholarWorksCommunities & CollectionsThis Collection

    My Account

    LoginRegister

    Statistics

    View Usage Statistics

    Contact KU ScholarWorks
    785-864-8983
    KU Libraries
    1425 Jayhawk Blvd
    Lawrence, KS 66045
    785-864-8983

    KU Libraries
    1425 Jayhawk Blvd
    Lawrence, KS 66045
    Image Credits
     

     

    The University of Kansas
      Contact KU ScholarWorks
    Lawrence, KS | Maps
     
    • Academics
    • Admission
    • Alumni
    • Athletics
    • Campuses
    • Giving
    • Jobs

    The University of Kansas prohibits discrimination on the basis of race, color, ethnicity, religion, sex, national origin, age, ancestry, disability, status as a veteran, sexual orientation, marital status, parental status, gender identity, gender expression and genetic information in the University’s programs and activities. The following person has been designated to handle inquiries regarding the non-discrimination policies: Director of the Office of Institutional Opportunity and Access, IOA@ku.edu, 1246 W. Campus Road, Room 153A, Lawrence, KS, 66045, (785)864-6414, 711 TTY.

     Contact KU
    Lawrence, KS | Maps