Date of Degree
12-2025
Document Type
Doctoral Project
Degree Name
Doctor of Nursing Practice (DNP)
Program
Nursing
Advisor
Maureen Rauschhuber PhD, MSN, RN
Abstract
ABSTRACT
Background: Urinary tract infections (UTIs) remain a leading cause of morbidity among elderly residents in long-term care facilities, where diagnosis is frequently delayed due to atypical presentation, cognitive impairment, and inconsistent urine specimen handling. Purpose: This quality improvement (QI) project aimed to improve the timeliness and accuracy of UTI management in a memory care facility through standardized evidence-based protocols. Objectives: The project sought to ensure that: (a) 100% of staff would be educated on the protocol; (b) 100% of residents with suspected UTIs would have urine sent for urinalysis and culture within 8 hours of symptom onset; (c) 100% of residents diagnosed with a UTI would receive appropriate evidence-based antibiotics within 12 hours of urinalysis results; (d) 80% of cultures would be resulted within 72 hours of collection; and (e) 100% of culture and sensitivity reports would be reviewed by a provider, with treatment adjusted as needed. Methods: Guided by the Plan-Do-Study-Act (PDSA) framework, interventions included staff education, implementation of a standardized antibiotic algorithm, and process improvements for urine collection and laboratory transport. Data were collected over 10 weeks, with compliance and outcomes tracked through de-identified resident records. Results: Six UTIs were identified with zero hospitalizations. Staff education reached 100%. Urine collection within 8 hours occurred in 88% of cases, while 68% of cultures were resulted within 72 hours. Antibiotic initiation within 12 hours of urinalysis results occurred in 92% of cases, and provider review of cultures reached 95%. Insurance-related lab restrictions were identified as the main barrier. Implications: Standardizing UTI management improved timeliness of care, enhanced antibiotic stewardship, and reduced preventable complications. This project highlights the role of doctoral-prepared nurses in leading sustainable quality improvement initiatives in long-term care.
Keywords: urinary tract infections, long-term care, quality improvement, elderly, nursing, antibiotic stewardship, dementia, timely diagnosis
Recommended Citation
Ojeda, Tania, "A Change in Practice: Improving UTI Management in a Long-Term Care Facility by Implementing Rapid Urinary Culture Collection Protocols to Enhance Timely Treatment and Reduce Hospitalizations" (2025). Doctor of Nursing Practice. 128.
https://athenaeum.uiw.edu/uiw_dnp/128