UTI Prevention in Long-Term Care: Costs, Target Population, and Nurses' Role, Thesis of Business Accounting

Download UTI Prevention in Long-Term Care: Costs, Target Population, and Nurses' Role and more Thesis Business Accounting in PDF only on Docsity! Interview Transcript 1 NURS 6050 Advocating for the Nursing Role in Program Design and Implementation Walden University NURS 6050: Policy and Advocacy for Improving Population Health With their patients, in their jobs, and in their neighborhoods, nurses naturally advocate. The critical role they play in advancing access to high-quality, accessible care is given a voice by nurses. Each nurse will help the profession grow and progress to higher levels with a strong engagement in advocacy. Interviewer: Tell us about a healthcare program, within your practice. What are the costs and projected outcomes of this program? Interviewee: In the residents of long-term care (LTCs), urinary tract infections (UTIs) are commonly suspected and antibiotic prescriptions were widespread in these patients, even though these patients were asymptomatic. However, this strategy also has more damage than benefit and leads to a rise in adverse drug effects and to more frequent drug-resistant bacterial infections. It does not enhance genitourinary symptoms, e.g. polyuria or smelly urine or thus contribute to increased mortality, which makes it imperative for UTIs to be differentiated from asymptomatic bacteriuria. The cost on the UTI program and outcomes The cost of a $32,108 service will be a 190-bed long-term care hospital. The catheter-based urinary tract prevention programmed, by cost reduction and better health outcomes, is expected Interview Transcript 2 to help payers. The costs for intervention shall include costs for the conduct and supervision of the intervention program by an infection control specialist, costs for attending educational events by nursing staff, nursing time for donating protective equipment, supplies of hand hygiene and barrier precautions and interactive educational content. Our analyzes show that a targeted intervention infection control program will result in 8.7 fewer catheter-associated urinary tract infections and 2.9 fewer long-term care hospitals a year. Interviewer: Who is your target population? Interviewee: Any long-term care facility patient at risk and some factors result from a combination of physiological changes of aging and accumulation of comorbidities. And any patients with diabetes, cancer, and autoimmune disorders. Furthermore, the co-morbidity causing bladder and bowel incontinence and physical declines (i.e. dementia, stroke, Parkinson's disease). Interviewer: What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples? Interviewee: The role of the nurse would be to Complete the three implementation-planning phases (Assess, Plan, Implement) AND are successful in putting the recommended implementation strategies into practice. Best practices highlight urinary culture in residents when clinical symptoms of a UTI are determined; antibiotics are administered only when stated requirements is met; antibiotic therapy has been re-evaluated after urine and vulnerability findings have been obtained. This policy would restrict the use of antibiotics in residents of long- term care facilities. An example Interview Transcript 5 Interviewer: Who are the members of a healthcare team that you believe are most needed to implement a program? Can you explain why? Interviewee: Training will bring staff together to learn and address issues relating to anti-biotic overuse, signs that suggest a UTI and new UTI evaluation documentation organizational processes. All staff that are directly involved in clinical decision making i.e., Registered Nurses, Nurse Practitioners and Physicians. Practitioners are the focus since they are the ones prescribing the antibiotics. A letter is sent to each doctor explaining that the nursing home standards are based on clinical standards. The facility agreed to upgrade the urinalysis protocol in order to maximize its use of antibiotically regulated antibiotic products in the treatment of UTI diseases. UTI It is a research-driven disease that is caused by suspicious urinary system SBARS for the case, history, assessment and contact between nurses and clinicians to obtain vital information. This implementation guide was developed to support long-term care facilities to implement the UTI Program. It provides a phased approach to implementing the practice changes in long-term care facilities, which are the core components of the Program. Good planning is key to success in implementing and sustaining the UTI program. Taking time to consider how to implement the UTI Program will save time in the long run. References Genao, L., & Buhr, G. T. (2012). Urinary Tract Infections in Older Adults Residing in Long- Term Care Facilities. The annals of long-term care : the official journal of the American Medical Directors Association, 20(4), 33–38. Interview Transcript 6 Hutton, D. W., Krein, S. L., Saint, S., Graves, N., Kolli, A., Lynem, R., & Mody, L. (2018). Economic Evaluation of a Catheter-Associated Urinary Tract Infection Prevention Program in Nursing Homes. Journal of the American Geriatrics Society, 66(4), 742–747. https://doi.org/10.1111/jgs.15316 Publichealthontario. (2019 November). Urinary Tract Infection (UTI) Program: Implementation Guide, Second Edition. Retrieved October 22, 2020, from https://www.publichealthontario.ca/-/media/documents/U/2019/uti-implementation- guide.pdf?la=en