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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/one-pager-UTI.docx
June 01, 2021 - DiagnosisUrinary Tract Infections (UTI)
· First, ask about SYMPTOMS … frequency, urgency, suprapubic pain1,2
· Pyelonephritis: fever, rigors, flank pain1
· Catheter-associated UTI … subrapubic pain and fever; residents with catheters may not report dysuria, frequency, or urgency2,3
· If UTI … residents with a positive UA and/or culture until confirming that relevant symptoms are present.5-8
· UTI … days14
TMP/SMX or IV/oral cephalosporin: 10–14 days (10 days if early response)15,16
Complicated UTI
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/assess-resident-UTI-facilitator-guide.docx
June 01, 2021 - Slide 4
Diagnosing a UTI
SAY:
Let’s review the signs and symptoms of a UTI.
… Laboratory tests alone do not tell us if someone has a UTI. … So, she does not have a UTI. She has asymptomatic bacteriuria. … If you choose, “He probably has a UTI because the urine is cloudy”, or “He probably has a UTI because … We learned in case 1 that dysuria alone can suggest a UTI.
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/manage-resident-UTI-facilitator-guide.docx
June 01, 2021 - UTI. … Melba is having dysuria, or pain with urination, so she should be evaluated for a UTI. … Fourteen days is the longest course recommended to treat a UTI. … Since Billy is a male with a UTI, by definition he has a complicated UTI. … Additionally, the presence of a urinary catheter makes his UTI complicated.
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www.qualitymeasures.ahrq.gov/nhguide/toolkits/determine-whether-to-treat/toolkit1-suspected-uti-sbar.html
October 01, 2016 - What is the Suspected UTI SBAR Toolkit? … The primary tool in this toolkit is the Suspected UTI SBAR form. … Introduce the Suspected UTI SBAR form to prescribing clinicians. … clinicians when a suspected UTI case arises. … Suspected UTI SBAR Toolkit. Content last reviewed October 2016.
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/poster-4x6-UTI.pdf
June 01, 2021 - Suspected Urinary Tract Infection (UTI) in Long-Term Care Residents
0%0% … Suspected Urinary Tract Infection (UTI) in
Long-Term Care Residents
Signs & … Symptoms of a UTI
For Residents Without
a Urinary Catheter
� Dysuria
OR
� Fever (>100°F … and UCx results, if resident appears ill
� If UA & UCx are positive and the resident has ongoing UTI … No. 17(21)-0029
June 2021
Signs & Symptoms of a UTI
References
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/family-members-UTI.pdf
June 01, 2021 - • Dark, foul-smelling, and cloudy urine are not enough to decide if someone
has a UTI. … without vital sign changes suggesting
infection or urinary symptoms are rarely, if ever, symptoms of a UTI … • Many older people get an antibiotic for UTI treatment even though they
do not have symptoms of … a UTI … • Antibiotics do not help when there are no UTI symptoms, and we have
newer data indicating that
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/assess-resident-UTI-slides.pptx
June 01, 2021 - Use – Long-Term Care
Assessment UTI
2
Case 1: Mary Ann
Test Name Results Units Ref. … 3
Case 1: Question 1
Your colleague thinks the resident has a UTI. … Do you think she has a UTI? … This is
NOT
a UTI! … Options:
“He probably has a UTI because his urine is cloudy.”
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/nhguide/4_TK1_T4-Urinalysis_and_UTIs_Improving_Care_Final_0.docx
October 01, 2016 - We will discuss:
Signs and symptoms of UTIs
Three common myths about UTIs
What Is a UTI? … A UTI is an infection in any part of your urinary system. … Signs and Symptoms of a UTI
Question: What are the signs and symptoms of a UTI? … It may not be a UTI. … What are some things we could do to help reduce residents’ risk of a UTI?
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/nhguide/4_TK1_T1-SBAR_UTI_Word_simplified_one_page.doc
August 26, 2016 - Suspected UTI SBAR
Complete this form before contacting the resident’s physician. … ______________________
Phone______________________
SITUATION
I am contacting you about a suspected UTI
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/poster-8x11-UTI.pdf
June 01, 2021 - Suspected Urinary Tract Infection (UTI) in Long-Term Care Residents … and UCx results, if resident appears ill
� If UA & UCx are positive and the resident has ongoing UTI … modify antibiotics or start antibiotics (if not receiving active antibiotics)
Signs & Symptoms of a UTI … Suspected Urinary Tract Infection (UTI) in
Long-Term Care Residents
Ashraf … The Improving Outcomes of UTI
Management in Long-Term Care Project (IOU) consensus guidelines for the
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/ambulatory-care/uti-slides.pptx
September 01, 2022 - No. 17(22)-0030
September 2022
ASB and UTI
AHRQ Safety Program for Improving Antibiotic Use – Ambulatory … Care
1
Objectives
Distinguish asymptomatic bacteriuria (ASB) from urinary tract infection (UTI) … ASB and UTI
AHRQ Safety Program for Improving Antibiotic Use – Ambulatory Care
3
The Four Moments of … a UTI. … Recent antibiotic use
Complicated UTI suspected
Symptoms of pyelonephritis
ASB and UTI
AHRQ Safety
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/manage-resident-UTI-slides.PPT
June 01, 2021 - No. 17(21)-0029
June 2021
UTI Management
1
Objectives
Describe empiric treatment options for urinary … for de-escalation of antibiotic therapy for UTIs after additional clinical data are available.
2
UTI … NOT
a UTI! … Management
Diagnosing a UTI
5
OR
Dysuria
(pain with urination)
Systemic Signs
(fever or chills … Based on Melba’s symptoms, a urinalysis and culture should be obtained
UTI Management
6
Case
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www.qualitymeasures.ahrq.gov/antibiotic-use/long-term-care/best-practices/uti-assess.html
June 01, 2021 - presenting this presentation, viewers will be able to—
Explain the terms urinary tract infection (UTI … Recognize the signs and symptoms of a suspected UTI that should be reported to and discussed by the health … https://www.ahrq.gov/antibiotic-use/long-term-care/best-practices/uti-assess.html
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/ambulatory-care/uti-guide.docx
September 01, 2022 - of symptoms of a UTI. … Foul-smelling or cloudy urine by itself does not indicate a UTI. … able to verbalize the presence of UTI symptoms, making the criteria for diagnosing a UTI in children … A complicated UTI is any UTI in an adolescent or adult male or a UTI occurring in the presence of obstruction … pyuria is helpful to exclude the diagnosis of a UTI.
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/cauti-ltc/modules/implementation/educational-bundles/urine-culturing/antibiotic-stewardship/case-study-key.docx
March 01, 2017 - Valerie has a history of frequent urinary tract infections (UTI). … Over the last year she has been admitted to the hospital twice for UTI and has had multiple courses of … Johnny thinks his mother might have another UTI and wants her started on antibiotics right away.
1. … [endnoteRef:1] Cloudy, smelly urine does not meet the UTI criteria. … /LTC/LTCF-UTI-protocol_FINAL_8-24-2012.pdf.]
2.
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/nhguide/6_TK1_T5-Suspect_a_Urinary_Tract_Infection_brochure_MA_Coalition_final.pdf
June 18, 2015 - »Confusion or sudden behavior changes don’t
necessarily indicate a urinary tract infection (UTI)? … long-term care
settings will test positive for bacteria in their urine,
without actually having a UTI … So if a test shows bacteria, does this mean I have a UTI?
Not necessarily. … What are the specific symptoms of a UTI? … UTI is less likely without the specific symptoms listed above.
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/ambulatory-care/uti-one-pager.pdf
September 01, 2022 - o Treating asymptomatic bacteriuria can increase the risk for a UTI in the future3-4
• Review prior … sulfamethoxazole
Duration
• Cystitis: 3–5 days is typically sufficient2
• Pyelonephritis or complicated UTI … time
AHRQ Safety Program for Improving Antibiotic Use – Ambulatory Care ASB and UTI
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/nhguide/4_TK1_T2-Clinician_letter_Final_0.docx
October 01, 2016 - We will use a research-based and effective Toolkit, the Suspected Urinary Tract Infection (UTI) Situation … The Suspected UTI SBAR form is intended to enhance communication and provide guidance regarding managing … Although residents with specific UTI symptoms like dysuria usually need treatment, urinalyses and cultures … Suspected UTI SBAR Toolkit
However, research provides no evidence that treating asymptomatic bacteriuria … Embedded in the Suspected UTI SBAR form is our new protocol for initiating antibiotics for UTIs.
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/nhguide/6_TK1_T6-Managing_Resident_and_Family_Expectations_Final.pdf
October 01, 2016 - the residents or family members keep requesting antibiotics for
UTIs when a resident does not have a UTI … Have you ever had an experience where someone requested an
antibiotic for what they thought was a UTI … • In both of these talking points, it discusses what the true indicators of a UTI are,
how we treat UTIs … • Looking over the UTI points, would these have been helpful for any discussions you
have had with
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/cauti-ltc/modules/resources/tools/reduce/4-things.pdf
March 01, 2017 - Urinary Tract Infection (UTI) Event for Long-term Care Facilities. … Centers for Disease Control and Preven-
tion; January 2016. http://www.cdc.gov/nhsn/pdfs/ltc/ltcf-uti-protocol-current.pdf … epididymis, or prostate
■ Pus around the catheter
* See CDC's January 2016 "Urinary Tract Infection (UTI … www.cdc.gov/nhsn/PDFs/pscManual/2PSC_IdentifyingHAIs_NHSNcurrent.pdf
http://www.cdc.gov/nhsn/pdfs/ltc/ltcf-uti-protocol-current.pdf … http://www.cdc.gov/nhsn/pdfs/ltc/ltcf-uti-protocol-current.pdf