Nursing Home Urinary Tract Infection Problems Due to Lack of Proper Prevention: Study

According to the findings of new research, many nursing homes and long-term care facilities throughout the U.S. may not be taking proper preventative measures to protect residents from urinary tract infections, with proactive monitoring policies often not implemented.

A study by researchers from New York City’s Columbia University School of Nursing was presented at the annual meeting of the Association for Professionals in Infection Control (APIC) and Epidemiology last week, indicating that an average of five percent of nursing home patients suffer from urinary tract infections (UTIs) during any given month, indicating that many of the cases may be caused by a failure to enact preventative policies that monitor and mitigate the possibility of infection.

Nursing homes are expected to take proactive measures to protect residents from the risks of such infections, and failing to do so could be considered a sign of nursing home neglect.

A UTI is when bacteria enters the urinary tract through the urethra and moves up the tract to infect the bladder or kidney, commonly leading to symptoms of fever, chills, nausea, vomiting, and severe abdominal pain. However, if left untreated by antibiotics, patients may become dehydrated and the infection could enter the bloodstream and become fatal.

It is more common for women to suffer from UTIs than men. In fact, an anticipated one out of every five women experience a UTI at some point in their life and this often results in a more common occurrence.

The team of researchers surveyed 955 nursing homes in 2014, and analyzed data from the Centers for Medicare and Medicaid Services to determine the effectiveness of the current U.S. nursing homes policies and practices to prevent UTIs. The data indicated that for over 88,000 nursing home residents included in the study, over five percent, or 4,700, had suffered from a UTI while under the homes care.

Lead author Carolyn Herzig presented at the meeting that patients receiving catheters were four times more likely to develop a UTI than those without the devices. Patients are susceptible to developing infections through the use of an inserted indwelling urinary catheter.

However, the researchers discovered during the study that most UTI reports were not associated with the use of a catheter and had developed through failures to use bladder ultrasound scanners, cleaning the collection bag, and a lack of staffing infection preventionists. Of the 955 nursing homes reviewed throughout the study only about one in five facilities used a portable bladder ultrasound scanner to determine if the patient had voided all of the urine in their bladder. Facilities with the scanners were recorded to be ten percent less likely to have high rates of UTI infections.

Only one in every five facilities examined had a policy to clean the urine collection bag attached to the catheter device that could allow bacterium to travel to the urinary tract. This practice was estimated to cut catheter-linked UTI rates by 20%.

Researchers identified only nine percent of the facilities employed some sort of infection preventionist on staff that was credited through APIC training that is estimated to decrease high infection rates as much as 20%.

Typically, UTIs cause painful urination and foul urination odors that coherent patients can relate to medical personnel so that they may be treated with antibiotics to cure the infection. However, the elderly, nonverbal patients, or those with dementia or cognitive impairment usually cannot report traditional UTI symptoms, often resulting in delayed treatment. Delayed treatment for these classes of patients can be fatal given their weakened state.

When clinically necessary to use indwelling catheterization, UTIs are always a possibility. Although they are a threat, the proper continuous assessment for symptoms and preventative protocols can mitigate the possibility for infections to become life threatening and require hospitalization.

This latest study’s findings are considered preliminary until published in a peer-reviewed journal.