Feasibility of Algorithm-Based Clinical Decision Support for Suspected Urinary Tract Infections in Nursing Home Residents

• Published in: Antibiotics (Basel) Vol. 11; no. 10; p. 1276
• Main Authors: New, Garrett P., Nazir, Arif, Logan, Penny, Kistler, Christine E.
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 20.09.2022; MDPI
• Subjects: Algorithms; Antibiotics; Antiinfectives and antibacterials; antimicrobial stewardship; Attitudes; Brief Report; Care and treatment; Clinical decision making; clinical decision support; Confidence; Decision support systems; Diagnosis; Feasibility studies; Feedback; Health aspects; Infections; Infectious diseases; Intervention; long-term care; Nursing home patients; Nursing homes; Prescription writing; Urinary tract; Urinary tract diseases; Urinary tract infections; Urogenital system; Workloads; United States > US; Netherlands
• ISSN: 2079-6382; 2079-6382
• DOI: 10.3390/antibiotics11101276

Urinary tract infections (UTIs) are commonly suspected in nursing home (NH) residents, commonly resulting in antimicrobial prescriptions, even when symptoms are non-specific. To improve the diagnosis and management of suspected UTIs in NH residents, we conducted a pilot test of a paper-based clinical algorithm across NHs in the southern U.S. with ten advanced practice providers (APPs). The paper-based algorithm was modified based on the clinical care needs of our APPs and included antimicrobial treatment recommendations. The APPs found the UTI antimicrobial stewardship and clinical decision support acceptable. The educational sessions and algorithm improved baseline confidence toward UTI diagnosing and treatment. The APPs thought the algorithm was useful and did not negatively impact workload. Feedback from the pilot study will be used to improve the next iteration of the algorithm as we assess its impact on prescribing outcomes.