Healthcare Provider Interventions for Urinary Tract Infections at a Skilled Nursing Facility

PURPOSE. Urinary tract infections (UTIs) are the most common bacterial disease among elderly residents of skilled nursing facilities in the United States. For quality improvement, this study evaluated whether intervention strategies reduced risk and prevalence of UTIs at a local long-term care facility. SUBJECTS. The interventions took place at an 84-bed long-term care facility. The target population consisted of 71 nursing staff and three medical employees. METHODS AND MATERIALS. Interventions from September through mid-December 2015 included skills fairs, communication tools, and education on prescribing practices. A confidential follow-up survey was administered to nursing staff. Additionally, monthly counts of UTI cases and patient censuses were obtained from facility records for March 2015 through January 2016. ANALYSES. Poisson regression analysis was used to estimate whether incidence and prevalence of UTIs changed between the pre- and post-intervention periods. A qualitative assessment of the survey results was used to identify themes and future intervention targets. RESULTS. Preliminary results suggested declines in both incident (risk ratio=0.51; 95% confidence interval: 0.23-1.14) and prevalent (prevalence ratio=0.40; 95% confidence interval: 0.12-1.35) cases of UTI although these effects were not statistically significant. Fourteen of 56 eligible nursing staff (25%) completed the survey. They identified the hydration component of the skills fair as particularly helpful, but gave few suggestions for future interventions. CONCLUSIONS. Preliminary results suggest a reduction in UTIs among the elderly population; future analyses will incorporate data from additional post-intervention months to determine whether these results hold. However, continued success is dependent on identifying and implementing future interventions