Reducing the treatment of asymptomatic bacteriuria in seniors in a long-term care facility.

Cases of asymptomatic bacteriuria (ASB) in elderly people are often treated with antibiotics, but current guidelines recommend that bacteriuria in seniors not be treated unless it is associated with a urinary tract infection (UTI). Stanford Place Care Campus is a 182-bed complex-care facility in Parksville, B.C., catering primarily to seniors. To increase the accuracy of the clinical diagnosis of UTIs and reduce the treatment of ASB in this facility, the author developed a self-learning package and a clinical pathway to help nurses and other care providers better assess, manage and monitor residents with suspected UTIs. She also provided education sessions for the nursing and support staff. In the year after the new clinical pathway was introduced, the number of treated UTIs decreased, as did the percentage of treated UTIs that had been inadequately assessed (i.e., diagnosed solely on the basis of a dipstick urinalysis).