Maria D Mendoza De la Garza, Natalie F Mohammad, Molly J DiTommaso, Angie L Bicknese, Kirsten B Kaffine, Brandon P Verdoorn
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引用次数: 0
Abstract
Purpose: We designed a nurse-led algorithm to standardize urinary tract infection (UTI) diagnosis for older adults receiving home-based medical care. Aims of this pilot quality improvement study were to reduce the frequency of empiric antibiotic therapy initiated without a urinalysis and urine culture (UA/UC) first being obtained, reduce antibiotic use without a concomitant increase in emergency department (ED) visits or hospital admissions, and ensure stakeholders' satisfaction with algorithm use.
Method: A nurse-led diagnostic algorithm was designed and pilot-tested to address challenges and standardize diagnosis of UTI in a population of homebound older adults.
Results: In pre/post data analysis, algorithm implementation was associated with improved frequency of obtaining UA/UC before empiric antibiotic therapy was initiated, but the overall rate of antibiotic use for UTI did not decrease. No increase in ED or hospital admissions was identified.
Conclusion: Use of a diagnostic algorithm for UTI among homebound older adults was associated with reduced frequency of empiric antibiotic initiation for suspected UTI without a UA/UC first being obtained. More rigorous study is needed to confirm and expand on these findings. [Research in Gerontological Nursing, 17(2), 92-97.].
目的：我们设计了一种由护士主导的算法，以规范接受家庭医疗护理的老年人的尿路感染（UTI）诊断。这项质量改进试点研究的目的是降低未首先进行尿液分析和尿培养（UA/UC）就开始经验性抗生素治疗的频率，减少抗生素的使用，同时不增加急诊科（ED）就诊或入院人数，并确保利益相关者对算法使用的满意度：方法：设计并试点测试了一种由护士主导的诊断算法，以应对挑战并规范居家老年人群的尿毒症诊断：结果：在前后数据分析中，算法的实施提高了在开始经验性抗生素治疗前获取 UA/UC 的频率，但 UTI 抗生素的总体使用率并未降低。没有发现急诊室或医院入院人数增加：结论：在居家老年人中使用UTI诊断算法可减少在未首先获得UA/UC的情况下对疑似UTI使用经验性抗生素的频率。需要进行更严格的研究来证实和扩展这些发现。[老年护理研究，xx（x），xx-xx]。
期刊介绍：
Research in Gerontological Nursing is a forum for disseminating peer-reviewed, interdisciplinary, cutting-edge gerontological nursing research and theory to investigators, educators, academicians, clinicians, and policymakers involved with older adults in all health care settings. The Journal accepts manuscripts reporting research, theory, integrative and systematic reviews, instrument development, and research methods with the aims of improving the wellness and quality of care of the older adult population. Theory papers should advance gerontological knowledge, and integrative reviews should provide an analysis of the state of the science and provide direction for future research.
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