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. 2022 Sep 20;11(10):1276.
doi: 10.3390/antibiotics11101276.

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

Garrett P New  1 , Arif Nazir  2 , Penny Logan  2 , Christine E Kistler  3   4
Affiliations

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

Garrett P New et al. Antibiotics (Basel). .

Abstract

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.

Keywords: antimicrobial stewardship; clinical decision support; long-term care; nursing homes; urinary tract infections.

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Conflict of interest statement

Kistler is a paid consultant for Base10 Genetics on an electronic UTI decision support algorithm, though not the one tested in this study. None of the remaining authors have any conflict of interest, either personal or financial, to report, though both Arif Nazir and Penny Logan are employed by the same nursing home organization that employed the APPs in this research.

Figures

Figure 1
Figure 1
Clinical decision support algorithm for UTI diagnosis and management.
See this image and copyright information in PMC

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