...Urinary Tract Infection in the Geriatric Population Elizabeth Shultz Abstract The geriatric population is very vulnerable to Urinary Tract Infection (UTI) and its negative consequences. If left untreated, UTI in the elderly patient can have negative consequences such as delirium or even death. UTI can also contribute to the onset of acute or chronic kidney infections, which could permanently damage the kidneys and result in renal failure. In view of this, the purpose of this paper is to review related literature to find current evidence or best practices related to UTI in the geriatric population and to objectively critique the evidence. CINAHL and MEDLINE computer databases were mainly searched from January, 2005 to January, 2015 using a combination of manual and computer-based methods. Keywords: elderly, urinary tract, elderly infection management, urinary tract infection prevention, elderly and UTI. Introduction By convention, a Urinary tract infection (UTI) is defined either as a lower tract (acute cystitis) or upper tract (acute pyelonephritis) infection (Nicolle, 2014). Urinary tract infection (UTI) is the most common infectious problem among older adults both in the community and institutional settings (Midthun, Paur, Bruce, & Midthun, 2005). The elderly population is most likely to experience UTI due to many reasons, not the least of which is their overall susceptibility to all infections...
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...problems and issues that the healthcare setting have encountered. Theses guidelines reduce or decrease, “Never Events”, while improving quality care and patient safety. The purpose of this paper is to review the guidelines that has been developed to address the Urinary Tract Infections (UTI) problem, it’s importance and significance to nursing practice, as well as its impact on the patients and community, and the differences in care based on evidence. “Patients with indwelling catheters, even with current standards of care and evidence-based practice, urinary tract infections continue to be a problem”(Kevin J. Ribby, June 2006). Practice setting problem Urinary tract infections continue to be a problem in healthcare. The numbers of patient’s with urinary tract infections are still too high. “A plethora of articles have been written about nosocomial urinary catheter-related infections, management of the catheter, and proper placement of the indwelling catheter in the male patient 4 but little about the impact of nursing education on outcomes related to decreasing UTIs and usage of indwelling urinary catheters” (Doyle B, Zubina M, Horgan M, 2001). There are a various reasons for why nurses continue to see urinary tract infections like incorrect perineal cleaning, a break in aseptic technique when inserting urethral catheters, and the amount of time a urethral catheter remains in a patient. There have been various evidence-based practices that...
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...Urinary tract infections are common infections prevalent in bole males and females around the world. I am going to explain to you what an urinary tract infection (UTI) is, how it relates to the Helene Feld School of Nursing (HFSON) Conceptual Framework, nursing roles that relate to urinary tract infections, a care plan for urinary tract infection and evidence-based practice related to urinary tract infections. The urinary tract is composed of: two kidneys, two ureters, a bladder, a prostate (in men only) and an urethra; therefore an UTI is an infection of any of the foregoing organs, ducts and/or gland. Urinary tract infections vary depending on the location in the urinary tract and can be caused by a variety of mechanisms. The various factors...
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...u r na l of m e dic i n e Clinical Practice Caren G. Solomon, M.D., M.P.H., Editor Urinary Tract Infections in Older Men Anthony J. Schaeffer, M.D., and Lindsay E. Nicolle, M.D. This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors’ clinical recommendations. From the Feinberg School of Medicine, Northwestern University, Chicago (A.J.S.); and the University of Manitoba, Winnipeg, Canada (L.E.N.). Address reprint requests to Dr. Schaeffer at the Feinberg School of Medicine, Northwestern University, 303 E. Chicago Ave., Tarry Bldg. 16-703, Chicago, IL 60611, or at jschaeffer@ a northwestern.edu. N Engl J Med 2016;374:562-71. DOI: 10.1056/NEJMcp1503950 Copyright © 2016 Massachusetts Medical Society. An audio version of this article is available at NEJM.org 562 A 79-year-old community-dwelling man presents with urinary frequency, dysuria, and fever. Culture reveals extended-spectrum beta-lactamase Escherichia coli. He had a similar infection several months ago, with the same organism isolated, and he had a response to nitrofurantoin treatment. How would you further evaluate and manage this case? U The Cl inic a l Probl em rinary tract infection in men without indwelling catheters is uncommon among men younger than 60 years of age, but the...
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...The urinary tract is a body filtering system, that helps get rid of unwanted waste (Berkowits, 2007). A UTI can occur anywhere in genitourinary tract (Berkowitz, 2007). Although infectious agents can enter via hamatogenously into the urinary tract, most infections will start at the urethra then ascend (Berkowits, 2007). Most predisposing factor for an UTI includes catheterization, congenitally abnormalities of the genitourinary system or because of neurologic dysfunction in the bladder (Berkowitz, 2007). If a patient has a secondary spinal cord injury or diabetic neuropathy their susceptible to UTIs also (Berkowits, 2007). Women are more prone to getting UTIs than men, simply due to having a shorter urethra (Timby, 2010). Escherichia coli cause about 80% of all UTIs (Swearingen, 2008). Women experience more problems with Staphylococcus saprophyticus then any other type of bacteria (Swearingen, 2008). The bacteria survive by the dark moist warm environment in the urinary tract (Swearing, 2008). The urinary tract is created to keep out unwanted microscopic invaders, which does not always take action (Swearingen, 2008). The symptoms of an UTI can vary from person to person. A UTI depends on the patient, age, sex and where the infection is located. Most people experience dysuria, urinary frequency or urgency, back pain, difficulty walking, foul smelling urine (Timby, 2010). The color of the urine also can appear cloudy and have blood in it (Timby, 2010). Elderly patients...
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...| | |Child |Elderly |Young woman |Physician | | | | |person | | | |Ampicillin |treatment of ear |r |nr |nr |r | | |and throat | | | | | | |infections | | | | | |Cephalosporin |treatment for |nr |r |nr |r | | |people susceptible| | | | | | |to skin infections| | | | | |Ciprofloxacin |treatment of |nr |nr |r |r | | |urinary tract | | | | | | |infections | | | | | Questions 1. Why might a child be likely to develop ampicillin-resistant bacteria? Ampicillin is commonly given to children to treat ear and throat infections. The prevalence of these...
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...prescribe them as the traditional drug of choice for urinary tract infections and sexually transmitted diseases. Currently, the new development of antibiotics to combat illnesses caused by bacterial resistant strains and have limited the usefulness of Sulfa medications. Objectives Upon successful completion of this presentation you should be able to: • Understand and communicate your knowledge of Sulfonamides mode of action and bacterial resistance • Identify and understand the contra indications, common signs and symptoms of allergic reactions to Sulfonamides. • Identify 3 common trade names for sulfonamides and select indication for use between different patient population. Type and class of Pathogen Sulfonamides have been in use since the 1930's , these drugs are effective against both gram- negative and gram - positive bacteria. Sulfonamides are know as broad spectrum antimicrobial drugs; they are effective against a wide variety of microorganisms most Enterobacteriaceae, Chlamydia trachomatis, Nisseria, Haemophilus influenzae,, Norcardia, E.Coli , P. mirabilis some staphylococci, and many streptococci (with exception of Enterococcus faecalis). They are used for treatment of Protozoan such as Toxoplasma gondii, and mycobacterial. Sulfonamides are use for treatment and prophylaxis of Pneumocytis carinii and Shigella small bowel infections. Mode of Action Sulfonamides are bacteriostatic...
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...An APIC Guide 2008 Guide to the Elimination of Catheter-Associated Urinary Tract Infections (CAUTIs) Developing and Applying Facility-Based Prevention Interventions in Acute and Long-Term Care Settings About APIC APIC’s mission is to improve health and patient safety by reducing risks of infection and other adverse outcomes. The Association’s more than 12,000 members have primary responsibility for infection prevention, control and hospital epidemiology in healthcare settings around the globe. APIC’s members are nurses, epidemiologists, physicians, microbiologists, clinical pathologists, laboratory technologists and public health professionals. APIC advances its mission through education, research, consultation, collaboration, public policy, practice guidance and credentialing. Look for other topics in APIC’s Elimination Guide Series, including: • • • • Catheter-Related Bloodstream Infections Clostridium difficile Mediastinitis MRSA in Long-Term Care Copyright © 2008 by APIC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission of the publisher. All inquires about this document or other APIC products and services may be addressed to: APIC Headquarters 1275 K Street, NW Suite 1000 Washington, DC 20005 Phone: 202.789.1890 Email: APICinfo@apic.org Web: www.apic.org ISBN: 1-933013-39-7 ...
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...CHAPTER ONE 1. INTRODUCTION 1.0 DEFINITION OF TRADITIONAL MEDICINE, HERBAL PREPARATION AND FINISHED HERBAL PRODUCTS The World Health Organization (WHO) defines traditional medicine as the sum total of knowledge, skills and practices based on the theories, beliefs and experiences indigenous to different cultures. Traditional medicine is used in the maintenance of health the prevention, diagnosis, improvement or treatment of physical and mental illness, whether explicable or not and is passed on from generation to generation. Herbal Preparations contain plant parts or plant material in the crude or processed state as active ingredients and may contain excipients. (WHO, 1996a; Busse, 1999). Combinations with chemically defined active substances or isolated constituents are not considered herbal preparations (Busse, 2000; GNDP, 2004). According to the European Medicine Evaluation Agency (EMEA), herbal preparations are medicinal products containing exclusively herbal drugs or herbal drug preparations as active substances (WHO, 1996b; Busse, 2000). Several chemical constituents with different pharmacological targets are involved in the therapeutic action of herbal preparations. This may be an advantage compared to single isolated compounds, especially when the underlying disease has a multifactorial etiology which is the case in many chronic illnesses. Herbal preparations may include comminuted or powdered plant material, extracts, tinctures, fatty or essential oils of...
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...In nursing care it is essential to ensure the patient is safe and ethical principles are being followed. In 1979, The Belmont Report was created to provide ethical principles and guidelines to guide human research and studies. The Belmont Report focuses on three ethical principles: respect for persons, beneficence, and justice. This paper will discuss a study regarding hospital acquired urinary tract infections and determine if the ethical principles from The Belmont Report are evident. Quality Indicator Research Study: Urinary Tract Infections A quality indicator, also known as QIs, “are standardized, evidence-based measures of health care quality that can be used with readily available hospital inpatient administrative data to...
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...The urinary tract is the body’s drainage system for removing urine, which is composed of wastes and additional fluid. In sequence for normal urination to happen, all body parts in the urinary tract require to work as one in the proper order. The lower urinary tract includes the bladder and urethra. (National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC), 2012). Urination is the process of emptying the bladder. To urinate, the lower urinary tract has two detached phases of activity: the storage (or guarding) phase, when urine is collected in the bladder; and the voiding phase, when urine is unconfined through the urethra The state of the reflex system is reliant on both a conscious signal from the brain and the firing rate...
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...recently developed a poster and video approach with special focus on alternatives to urinary catheterization, removing catheters early, and the reinforcement of sterile technique prior insertion and foley catheter care were used to educate nursing staff and improve outcomes. The purpose of this paper is to educate nursing on how to be proactive with this issue and to inform the providers when there is no further need for the catheters to reduce infections in patients. Practice setting problem Urinary tract infections (UTIs) account for approximately 35% of nosocomial infections but are the lowest in mortality and cost (Burke, 2003). Patients with UTIs as a secondary diagnosis have an average length of stay of 9.1 days versus those without a urinary catheter of 4.7 days. As individuals live longer, the probability of them being hospitalized and requiring specialized care services is increased (Hobbs, 2001). Hospitalization of any aged person increases the risk for them to have a urinary indwelling catheter, which predisposes them to a nosocomial urinary tract infection (Saint, 2003).Nurses are responsible for placing and maintaining the indwelling catheters. Often non-licensed staff are being delegated these tasks, without the proper training and education on routine catheter care and catheter insertion. Importance of the clinical problem and its significance to nursing practice Nosocomial infections more than double the mortality and morbidity...
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...nosocomial infections that occurred within the past year. In your report, categorize the different parameters (i.e. person, time, place and ethnicity and gender) used in the compilation of data into the information summative. Hypothetically, Good Health Hospital is assumed to have possessed nosocomial infections as in any real hospitals where patients seek admission for treatment. According to Center for Disease Control and prevention (CDC), and Pennsylvania Department of Health (PADOH), a healthcare associated infection (HAI) which is also known as nosocomial infection is an infection that a person gets while staying as a patient in a hospital or other health care facility (PADOH, 2008). Hence, it is clearly understood that patients always acquired nosocomial infections during the process of receiving health care services from health professionals in any hospital or healthcare setting. PADOH has also confirmed that HAIs are the primary contributors of most sicknesses and mortalities in the world. For example, in American hospitals alone, HAIs account for about 1.7 million infections causing 99,000 deaths each year. Therefore, based on the analysis of Good Health Hospital records, research had shown that a great number of recent nosocomial infections that had happened before were identified. Among the different kinds of nosocomial infections verified, few infection type have been listed as followed: 1. Surgical site infection (SSI). 2. Urinary tract infection (UTI). 3....
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...Medicare Part A, B, and D. Medicare part A covers inpatient care in hospitals, skilled nursing facilities, hospice care, and home health care. Medicare part A covers 80% of the 5 day inpatient hospital stay for your mother’s visit, assuming she does not have a supplemental insurance, she will be billed for the 20% portion of the hospital bill that Medicare does not cover. Her skilled nursing facility (SNF) stay will be covered by Medicare part A, however, she needs to pay a co-pay of $141.50 for day 21 of her stay as Medicare covers the first 100 days of SNF but the patient is responsible to pay a co-pay for days 21-100. Your mother should not be responsible for paying days 22-40 as the urinary tract infection your mother developed was a hospital acquired infection, also called a nosocomial infection and the Hospital will not be reimbursed by Medicare for the expense this preventable condition generated (Cherry & Jacob, 2008). Medicare part B covers medically necessary services and supplies (services like dialysis, health and wellness screenings, and cardiac rehab and supplies like oxygen, walkers, canes, and diabetic supplies ) as well as preventive services like the flu and pneumonia vaccines (www.medicare.gov). In your mother’s case, her doctor has filled out a prescription for her medically necessary walker and our case manager has arranged the delivery of the walker with a Medicare approved supplier. Her walker will be covered 80% by Medicare and she will have to pay the 20%...
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...hemorrhagic diarrhea. This diarrhea illness was first recognized when the CDC personnel isolated e-coli from patients in two separate outbreak one in Oregon and the other in Michigan. The illness also was associate with eating hamburgers at a restaurant of a national chain. Some people experimented inflammation and bleeding of the colon. Infections dealing with e-coli are more common during the summer season and in northern states. Some strains of e-coli bacteria can cause anemia of kidney failure which leads to death. Other strains of e-coli can cause infection throughout the body such as the urinary tract and many more. By coming into contact with the feces, or stool of humans and animals you can get e-coli.it is normally inhabitant in small intestines and colon but do not cause diseases in the intestines. But can cause a disease if spread outside the intestines. For example the urinary tract which cause bladder or kidney infections or it can also get in the blood stream. Nearly every urinary tract infection is caused by e-coli. E-coli is a major health problem. Researchers suggest that it only takes a small number of e-coli to cause an infection in...
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