Infection control is a critical aspect of healthcare, especially in long-term care (LTC) facilities where residents are more vulnerable to infections like urinary tract infections (UTIs). UTIs are a common and often recurring issue in this setting, requiring vigilant management and prevention strategies to safeguard the health and well-being of residents. In this blog, we’ll explore key aspects of infection control related to UTIs in LTC, including prevention strategies, early detection, and effective treatment approaches.

Prevention Strategies:

Preventing UTIs starts with implementing robust infection control measures which include the following:

      • Encourage staff to practice proper hand hygiene, using soap and water or alcohol-based hand sanitizers regularly.
      • Emphasize the importance of maintaining a clean and hygienic environment, especially in areas where residents receive care or use restroom facilities.
      • Promote hydration among residents to ensure adequate urine flow, which helps flush out bacteria from the urinary tract.
      • Encourage regular toileting and avoid catheter use whenever possible, as catheters increase the risk of UTIs.
      • Educate staff and residents about the importance of proper perineal care and avoiding unnecessary antibiotic use, which can contribute to antibiotic resistance.

Early Detection:

Early detection of UTIs is crucial for timely intervention and preventing complications. Train staff to recognize common UTI symptoms such as frequent urination, urgency, burning sensation during urination, cloudy or foul-smelling urine, and abdominal or lower back pain. Implement systems for regular monitoring of residents’ urinary habits and any changes in their condition that may indicate a UTI.  Early detection of UTIs in LTC facilities can be facilitated by using standardized criteria such as McGeer’s criteria or equivalents.  McGeer’s criteria are widely recognized guidelines that measure the number of true infections and to estimate the incidence/prevalence of an infection, including UTIs, based on specific clinical signs and symptoms and diagnostic testing such as labs and x-rays.  Implementing McGeer’s criteria or similar tools can enhance the accuracy of UTI diagnosis and ensure appropriate management strategies are initiated promptly.

Incorporate electronic health record systems or documentation templates that align with McGeer’s criteria, enabling standardized assessment and documentation of UTI-related information. Utilize decision-support tools within electronic systems to guide clinicians in determining when further diagnostic testing, such as urine analysis or culture, is warranted based on the presence of criteria-defined symptoms.

By integrating McGeer’s criteria or equivalent frameworks into early detection practices, facilities can improve the accuracy of UTI diagnosis, optimize treatment decisions, and enhance overall infection control efforts.

Effective Treatment Approaches:

When UTIs occur, prompt and effective treatment is essential to prevent complications and recurrence. Follow evidence-based guidelines for UTI management, including appropriate antibiotic selection based on susceptibility testing and resident-specific factors such as allergies and renal function. Emphasize the importance of completing the full course of antibiotics as prescribed to prevent antibiotic resistance.  Monitor residents’ response to treatment closely, including resolution of symptoms and normalization of urinalysis findings. Assess residents for any underlying factors contributing to UTIs, such as urinary retention, poor hydration, inadequate hygiene or indwelling catheters, and address these issues as part of comprehensive care planning.

Education and Training:

Continuous staff education and training are key components of successful infection control practices in LTC settings. Provide ongoing education sessions for staff on UTI prevention, recognition, and management protocols. Incorporate case studies, simulations, and interactive discussions to reinforce learning and problem-solving skills. Encourage a multidisciplinary approach to infection control, involving nursing staff, physicians, infection preventionists, and other healthcare professionals. Foster a culture of teamwork, open communication, and continuous quality improvement to enhance overall outcomes and resident satisfaction.

Infection control related to UTIs in LTC requires a comprehensive approach that encompasses prevention, early detection, effective treatment, and ongoing education. By implementing evidence-based practices, promoting a culture of safety, and collaborating across disciplines, healthcare teams can optimize outcomes and enhance quality of life for residents.

Join Proactive May 14th for the start of the webinar Immediate Jeopardy Risk: Infection Control. Learn from recent survey findings of IJ level deficiencies in IPC practices that will guide your facility to implement appropriate risk management safeguards to prevent similar infection control related citations. In addition, mark your calendar to register your Infection Preventionist for the new Proficient Infection Preventionist series starting in June.




Written by Brandy Hayes, RN, RAC-CT, RAC-CTA
Clinical Consultant

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