Date of Award

Spring 5-5-2018

Document Type

DNP Project

Project Team Faculty Member

Dr. Kathy Ketchum

Project Team Faculty Member

Dr. Kay Gaehle

Project Team Faculty Member

Dr. Lisa Green


Antimicrobial stewardship, antimicrobial resistance, urinary tract infections, asymptomatic bacteriuria, long term care, residents, practice guideline


Urinary tract infections (UTIs) are the most diagnosed infections requiring antibiotics in long-term care (LTC) facilities. The rising prevalence of antimicrobial resistance (AMR) threatens treatment of infections that were once responsive to antibiotic therapy. The inappropriate use of antibiotics in this Midwestern LTC facility provided the impetus for implementing a standardized clinical practice guideline (CPG) for diagnosing UTIs among the LTC residents. A data collection tool was developed for the audit that identified the specific assessment criteria for UTI management and eligibility criteria for antibiotics. Physicians and NPs at the LTC facility were administered a questionnaire prior to implementation of the CPG and education provided to the nursing staff. Data were collected pre- and post-implementation with analysis conducted to evaluate the change in a 12-week period before and after intervention. A total of 27.4% UTI cases was noted in the three-month pre-intervention period compared to 12.9% in the three-month post-intervention period showing a 14.5% reduction in the percentage of UTI cases. The incidence rate per 1000 resident days was reduced by 4.7 from pre- to post intervention. With increased adherence this CPG, the staff at this LTC facility can greatly minimize inappropriate antibiotic exposure among LTC residents over time.

Download Full Text Above

Included in

Nursing Commons



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.