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Literature Review Part Two Antibiotic resistance in the elderly is amongst one of the most urgent public health issues in healthcare. In the long term healthcare setting it is estimated that antibiotic treatment cost approximately $38 million to $ 137 million per year (CDC, 2013). The purpose of this paper is to identify clinical practices associated with antibiotic resistance in patients in long-term care facilities with urinary tract infections, different treatment options, and the prevalence of antibiotic resistance. The identified research reports will be analyzed and assessed in relation to the selected PICO question: in nursing home patients with UTIs what are the effects of treating the infection with antibiotics compared to not treating the infection with any antibiotic and how can it help reduce the incidence of antibiotic resistance? Background Urinary tract infections are the most common infections found in patients that reside in long-term care facilities (LTCF), accounting for approximately 20-30% of infections reported by long-term care facilities (CDC, 2012). When dealing with UTIs in LTCF, …show more content…
The intervention of this study consisted of mailing antibiotic guides to providers along with an antibiotic prescribing profile that targeted infections such as urinary tract infections, lower respiratory tract, and skin infections, and infections of unknown origin. At the end of the study results revealed that non-adherent prescriptions decreased by 20.5% in the experimental group and 5.1% in the controlled group (Monette, et al., 2007). The result of this case showed that education follows with a current antibiotic guide and prescription profile was useful in decreasing the amount of non-adherent prescription of antibiotics in patients that reside in
Public health officials estimate that up to 50% of all antibiotics use in the U.S is either unnecessary or in appropriate.
In the last decade, the number of prescriptions for antibiotics has increases. Even though, antibiotics are helpful, an excess amount of antibiotics can be dangerous. Quite often antibiotics are wrongly prescribed to cure viruses when they are meant to target bacteria. Antibiotics are a type of medicine that is prone to kill microorganisms, or bacteria. By examining the PBS documentary Hunting the Nightmare Bacteria and the article “U.S. government taps GlaxoSmithKline for New Antibiotics” by Ben Hirschler as well as a few other articles can help depict the problem that is of doctors prescribing antibiotics wrongly or excessively, which can led to becoming harmful to the body.
However, increasing antibiotic resistance patterns among intensive care unit pathogens, cultivated by empiric-broad spectrum antibiotic regimens, characterizes the variable concerns. Recent literature point that antibiotic use before the development of VAP is associated with increased risk for potentially resistant gran-negative infections and Methcillin-resistant Staphylococcus auereus (MRSA)
Catheter Acquired Urinary Tract Infections (CAUTIs) has become to be classified as one among the leading infections which most individuals end up being susceptible to acquire while at the hospital. Healthcare-associated or acquired infections (HAIs) are a significant cause of illness, death, and more often than not, have resulted to cost the tax payers potentially high medical expenses in most health care settings. ("Agency for Healthcare Research and Quality," para. 1) Due to this, 1 out of every 20 patients will end up with CAUTI within the US hospitals and this has caused Agency for healthcare research and quality (AHRQ) to embark on nationwide plans to help in the eradication and control of CAUTI incidences. ("Agency
Cystitis more commonly known as a urinary tract infection (UTI) or bacteriuria is a chronic infectious disease defined as inflammation of the urinary tract including the bladder and urinary tissue. Signs and symptoms develop due to aggravated epithelial tissue that line the bladder and urinary tract effected by the bacteria infecting them. There is a greater prevalence in women than in men, however when men develop a UTI they are at greater risk for complications such as pyelonephritis or septicemia (Lehne 2013). Bauman (2013) states that 32% of women will experience cystitis in their lifetime. Lehne (2013) states that up to 35% of sexually active females will develop a urinary tract infection each year and that up to 50% of females in nursing homes have cystitis at any given time.
For patients requiring longer acute care than what is generally given at an inpatient acute care hospital, The Long Term Acute Care Hospital is an option. To be admitted to an LTACH, patients are required to have “medically complex situations with a mean length of stay > 25 days” (Munoz-Price, 2009, p. 438 ). Examples of patients with complex acute care needs are those with multiple comorbidities who need mechanical ventilator weaning, administration of intravenous antibiotics, and those with complex wound care (Munoz-Price, 2009, p. 438). According to Landon Horton, CNO of Select Specialty Hospital in Fort Smith, Arkansas, “The services provided by LTACH facilities allow the patients to get home who would not otherwise, have a higher level of functioning at discharge, and increase their quality of life” (personal communication, March 7, 2014).
As such techniques were not used in this study, I defined a recurrent urinary tract infection as the presence of 2 10,000 col/ml of a single bacteria and one or more urinary symptoms occurring at least two weeks after the initial infection. This may lead to some misclassification of outcome; however, as long as the classification is not associated with the exposure(s) of interest the resulting measures of association should be biased toward the null hypothesis of no difference. The associations between hypothesized risk factors and repeat UTI were studied using multilevel contingency tables, with both stratification and multivariate techniques to control for confounding.3 I calculated six-month cumulative incidences of UTI, risk ratios (RR), and Mantel-Haenszel summary RRs. Exact 95 percent confidence intervals (CI) were calculated around each RR using the method of Gart.4 A three-level symptoms scale, (0 = no hematuria or urgency, 1 = urgency alone, 2 = hematuria and urgency) was developed and used both as a dependent and
Antibiotic resistance is one of the most important issues facing health care today, with wide reaching future implications if abuse continues. In the United States alone, antibiotic resistance is responsible for over two million illnesses and 23,000 deaths per year. Providers need to be judicious in the disbursement of these life saving pharmacological agents, while being informative of why antibiotics are not always the answer (Talkington, Cairns, Dolen, & Mothershed, 2014). In the case listed below, several issues need to be addressed including perception, knowledge deficit, and the caregiver’s role. This paper will focus on whether a prescription for antibiotics is appropriate and other courses of action that may be taken instead.
During patients education there are a host of other things to be explained to the patient in order to increase the patient’s awareness. According to Noble 2009, educating patient on the reason for the use of personal protectiveequipment will increase their awareness and the need for active involvement in the reduction of the spread of MRSA. Other information to be explained to the patient includes hand hygiene explanation of colonization and the scientific rationale for every item explained to the patient.
...s and measurement to decrease healthcare- associated infections. American Journal Of Infection Control, pp. S19-S25. doi:10.1016/j.ajic.2012.02.008.
Hospital-acquired bladder infections. These infections, occur in people in a medical care facility, such as a hospital or nursing home. Most often they happen in those who have had a urinary catheter placed through the urethra and into the bladder to collect urine, a common practice before surgical procedures, for some diagnostic test, or as a means of urinary drainage for older adults or people confined to bed.
Generally in life, an overabundance of anything is thought of as a blessing.For instance, most people would say that there is no point where someone has too much money, or too much time; however, having and using too many antibiotics can be a problem.With the advent of antibiotics in 1929 Fleming warned that, "The time may come when penicillin can be bought by anyone in the shops.Then there is the danger that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant."[1]Following with Fleming's words antibiotics need to be prescribed in a judicious fashion, not of one with a careless action, "one third of the 150 million outpatient prescriptions are unnecessary."[2]With the overuse of antibiotics today we have seen this very idea come to be.Over usage is caused most prevalently by a lack of education on the part of the patient.Thus stated, the way to overcome such a circumstance is to educate, not only the physician but also the patient.
Bacteria can be found in healthy urine, so usually a doctor bases it off symptoms and the lab tests. For the people with reappearing UTIs, and for patients in the hospital, the urine may be seriously infected and civilized. The experiment is resolved by placing part of the urine in a test tube with a certain substance that makes the bacteria multiply, after this process is finished, they can be identified. Another test that can be taken is the sensitivity test, the test tests for sensitivity to different medicines and antibiotics to see which medication is best for treating the persons severe infection. If a person has recurrent UTIs, the doctor may order some extra exams to determine if the person’s urinary tract can get back to being
Nursing diagnosis Hospital acquired infections are spread by numerous routes including contact, intravenous routes, air, water, oral routes, and through surgery. The most common types of infections in hospitals include urinary tract infections (32%), surgical site infections (22%), pneumonia (15%), and bloodstream infections (14%). a. (book). The most common microorganisms associated with the types of infections are Esherichila coli, Enterococcus species, Staphylococcus auerus, Coagulase-negative staphylococci, or Pseudomonas aeruginosa. Urinary tract infections occur when one or more microorganisms enter the urinary system and affect the bladder and/or the kidneys.
The scientific name of a kidney infection is known as pyelonephritis. There are two types of pyelonephritis infections, acute and chronic. Acute pyelonephritis is sudden and limited and can be cured/treated using antibiotics. However, if it is a chronic infection, it is long-lasting and occurs due to birth defects; it can lead to scarring in the kidneys, as well. Kidney infections can occur in both men and women. Although, according to Chih-Yen’s study of chronic infection, “Females (36.1%, 60/166) were more prone to have upper UTIs than males (11.8%, 13/110)” (Chih-Yeh, 2014; Chih-Yeh et al., 2014). In addition, age is not an important number due to the presence of Escherichia coli present in everyone’s body. It is dependent on time and health of an individual for the infection to present itself. Moreover, a study on children and adolescent transplantation concluded that, “UTI was uncommon in children after the first month of transplantation. Two significant risk factors for UTI were female gender and neurogenic bladder in this transplant population” (Fallahzadeh, 2011; Fallahzadeh et al., 2011). From the peer-reviewed papers, it is clear that females are more prone to UTI infection, overall, than