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Background: Antibiotics are often inappropriately prescribed for urinary tract infections (UTIs) in nursing home (NH) residents. Research emphasises the importance of prescribing antibiotics only if there are UTI-related signs and symptoms (S&S). However, for many NH residents it is challenging to find out whether such S&S are present, for example due to cognitive disorders.

Objectives: To provide insight into the assessment of UTI-related S&S in NH residents with impaired awareness or ability to communicate S&S, and to develop supportive tools for the observation of UTI-related S&S in this subgroup of NH residents, by nursing staff.

Methods: We performed a practice-based study using mixed methods. Data of 295 cases of suspected UTI were analysed to determine how often UTI-related S&S were 'not assessed/non-assessable' in residents with and without dementia. Barriers and facilitators in observing UTI-related S&S in NH residents with impaired awareness or ability to communicate S&S were derived from interviews and focus groups with nursing staff. Literature review, focus group data, additional telephone interviews and questionnaires with nursing staff were used in a step-by-step process, including pilot testing, to develop supportive tools for the observation of UTI-related S&S.

Results: UTI-related S&S were assessable in the majority of NH residents with dementia. The proportion 'not assessed/non-assessable' S&S in residents with dementia increased with increasing severity of dementia. In residents with very severe dementia, up to 58% of the S&S were 'not assessed/non-assessable'. Knowing the resident, working methodologically, and being sufficiently skilled to interpret observations in residents facilitate the assessment of UTI-related S&S. Insights acquired during the different study elements resulted in the development of an observation checklist and a 24-h observation tool.

Conclusions: The more NH residents have impaired awareness of ability to communicate S&S, the more difficult it seems to be to assess UTI-related S&S. The observation checklist and 24-h observation tool developed in the current study may support nursing staff in their observation of UTI-related S&S in this group of NH residents.

Titel:	Observation of urinary tract infection signs and symptoms in nursing home residents with impaired awareness or ability to communicate signs and symptoms: The development of supportive tools.
Autor/in / Beteiligte Person:	van Eijk J ; Rutten, JJS ; Hertogh, CMPM ; Smalbrugge, M ; van Buul LW
Link:	Full Text Finder (Volltext)
Zeitschrift:	International journal of older people nursing, Jg. 18 (2023-09-01), Heft 5, S. e12560
Veröffentlichung:	Oxford : Wiley, c2006-, 2023
Medientyp:	academicJournal
ISSN:	1748-3743 (electronic)
DOI:	10.1111/opn.12560
Schlagwort:	Humans Nursing Homes Anti-Bacterial Agents therapeutic use Urinary Tract Infections diagnosis Urinary Tract Infections drug therapy Dementia diagnosis Dementia drug therapy Nursing Staff
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [Int J Older People Nurs] 2023 Sep; Vol. 18 (5), pp. e12560. <i>Date of Electronic Publication: </i>2023 Aug 10. MeSH Terms: Urinary Tract Infections* / diagnosis ; Urinary Tract Infections* / drug therapy ; Dementia* / diagnosis ; Dementia* / drug therapy ; Nursing Staff* ; Humans ; Nursing Homes ; Anti-Bacterial Agents / therapeutic use References: Ashraf, M. S., Gaur, S., Bushen, O. Y., Chopra, T., Chung, P., Clifford, K., Hames, E., Hertogh, C. M. P. M., Krishna, A., Mahajan, D., Mehr, D. R., Nalls, V., Rowe, T. A., Schweon, S. J., Sloane, P. D., Trivedi, K. K., van Buul, L., Jump, R. L. P., & Infection Advisory SubCommittee for AMDA-The Society of Post-Acute and Long-Term Care Medicine. (2020). Diagnosis, treatment, and prevention of urinary tract infections in post-acute and long-term care settings: A consensus statement from AMDA's infection advisory subcommittee. 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Grant Information: Regional Cooperative Networks Antibiotic Resistance ('ABR zorgnetwerk') of Noord-Holland West and Noord-Holland Oost / Flevoland; The Netherlands Organisation for Health Research and Development Contributed Indexing: Keywords: dementia; long-term care facilities; nursing staff; observation tools; signs and symptoms; urinary tract infection Substance Nomenclature: 0 (Anti-Bacterial Agents) Entry Date(s): Date Created: 20230811 Date Completed: 20230912 Latest Revision: 20230912 Update Code: 20231215

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Observation of urinary tract infection signs and symptoms in nursing home residents with impaired awareness or ability to communicate signs and symptoms: The development of supportive tools.