Urinary tract infections (UTIs) are infections in the urinary system. A bacterium is caused by exposure to antibiotics or inappropriate catheter use (Gill et al., 2020). Long-term care patients may not recognize symptoms, leaving the infection untreated. Care providers need to prevent the development of this disease. This literature review evaluates UTI prevention in long-term care patients.
Methods of Searching
This literature review was conducted using electronic and manual resources. The sources of a local library proved UTI urgency in long-term care. Online databases allowed extending the report and including new articles. “Urinary tract infection,” “long-term care,” and “prevention” were the keywords. CINAHL, MEDLINE, and PubMed were surfed with publication and language inclusion criteria.
Project Proposal Topic
Nurses use both pharmacologic and non-pharmacologic methods to prevent UTIs. Prophylactic antibiotics, vaginal estrogens, and methenamine salts stabilize patients’ conditions (Ashraf et al., 2020). Mobility, education, catheter reduction, hydration, and cranberries intake are recommended (Ashraf et al., 2020; Lean et al., 2019). This project proposal reviews the most effective UTI prevention interventions. Its future implication may considerably improve the quality of care.
Review of the Literature
This review of literature examined several approaches to prevent UTIs. The first recommendation for patients is to use D-Mannose regularly. This sugar type blocks bacteria growth in the urinary system (Gill et al., 2020). Women with recurrent UTIs report positive results compared to nitrofurantoin (Gill et al., 2020). Communication with a doctor is necessary before choosing this intervention.
Another method for UTI prevention in long-term care is hydration improvement. Dehydration provokes new risks of UTIs among care home residents (Lean et al., 2019). Nurses should organize structured drink rounds and increase patient awareness (Lean et al., 2019). This intervention attracts much attention due to its low-cost resources. Great fluid intake reduces infections and enhances the patient’s well-being.
Not many people know that cranberries contribute to UTI reduction. LuĂs et al. (2017) conduct a systematic review to prove this association. Cranberry ingestion significantly reduces UTI incidence in long-term care patients (LuĂs et al., 2017). Berries contain proanthocyanidins that control infection likelihood, particularly E. coli. This intervention decreases antibiotic use and leads to positive outcomes.
Physical activity and mobility are recommended to reduce pharmacological interference. Older adults who need long-term care should manage urinary incontinence. Retrospective cohort studies prove UTI reduction with moderate aerobic exercises (Ashraf et al., 2020). When people move, they improve the quality of the bladder. The better the bladder’s condition is, the lower the UTI risks are.
Finally, UTI prevention is high if people obtain an education. Not all long-term care patients and nurses know UTI peculiarities. An education program consists of informative booklets, policies, and protocols (Zurmehly, 2018). After the courses, nurses take tests and check their knowledge. When people understand what provokes UTIs, they are ready to resist the risks.
Findings
The literature review has shown that pharmacologic and non-pharmacologic interventions are effective. People may choose appropriate cranberry diets and take safe medications (Gill et al., 2020; LuĂs et al., 2017). Nurses are responsible for regular assessments of patient urinary systems. Improved hydration is also a chance to stability patient health (Lean et al., 2019). Still, all these steps should be regulated by well-educated nurses.
Therefore, the recognition of organizational changes and behaviors is required. Nurses and patients need knowledge about UTIs and their progress. Communication and experience exchange become a part of UTI interventions (Ashraf et al., 2020; Zurmehly, 2018). When people report achievements or failures, they contribute to progress. UTIs have common symptoms, and nurses should recognize them in patients. Infection prevention is possible if long-term care facilities are prepared.
Conclusions
In general, UTIs are common infections in long-term care facilities. Nurses are aware of preventive strategies and use them regularly. Sometimes, patients neglect certain UTI symptoms and provoke additional problems. Hydration, dietary habits, physical activities, and education are crucial interventions to avoid new risks of UTIs among care home residents (Lean et al., 2019). Thus, UTI prevention should not be neglected in long-term care.
References
Ashraf, M. S., Gaur, S., Bushen, O. Y., Chopra, T., Chung, P., Clifford, K., Hames, E., Hertogh, C., Krishna, A., Mahajan, D., Mehr, D. R., Nalls, V., Rowe, T. A., Scheweon, S. J., Sloane, P. D., Tivedi, K. K., van Buul, L. W., & Jump, R. L. P. (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. Journal of the American Medical Directors Association, 21(1), 12-24. Web.
Gill, C. M., Hughes, M. S. A., & LaPlante, K. L. (2020). A review of nonantibiotic agents to prevent urinary tract infections in older women. Journal of the American Medical Directors Association, 21(1), 46-54. Web.
Lean, K., Nawaz, R. F., Jawad, S., & Vincent, C. (2019). Reducing urinary tract infections in care homes by improving hydration. BMJ Open Quality, 8(3). Web.
LuĂs, Ă‚., Domingues, F., & Pereira, L. (2017). Can cranberries contribute to reduce the incidence of urinary tract infections? A systematic review with meta-analysis and trial sequential analysis of clinical trials. The Journal of Urology, 198(3), 614–621. Web.
Zurmehly, J. (2018). Implementing a nurse-driven protocol to reduce catheter-associated urinary tract infections in a long-term acute care hospital. The Journal of Continuing Education in Nursing, 49(8), 372-377. Web.