Romina Lo-Montano, DNP(c), MSN, FNP

Best practice guidelines for uncomplicated urinary tract
infections to reduce rates of antibiotic resistance: A CE module
Romina Lo-Montano, DNP(c), MSN, FNP-C
Diane John, PhD, APRN, FNP-BC (Chair) - Sally Weiss PhD, RN, CNE, ANEF (Content Expert)
Frontier Nursing University, Hyden, KY
Introduction
v  Uncomplicated urinary tract infections (UTIs)
account for 8.6 million visits to clinics
v  Total cost of care, $2.4 billion annually.
v  Prescription medication costs $218 million.
v  Inappropriate antibiotic use and patient noncompliance gave rise to antibiotic resistance.
v  An alarming increase of 20% to 40% of resistance
to antibiotics commonly used to treat
uncomplicated UTIs such as TMP/SMX.
The Purpose
The purpose of this Clinical Doctorate Capstone Project was to develop an evidence-based (EBP)
continuing education(CE) module for the appropriate treatment of uncomplicated UTIs in women.
Module objectives:
v  To be able to differentiate between complicated and uncomplicated urinary tract infections.
v  To describe the symptoms of uncomplicated UTI.
Conclusion
v  CE module for Primary Care Providers in various
settings
v  The CE module will be submitted to the Arizona
Nursing Association (AZNA) for approval of one
credit hour.
v  Seeking manuscript publication in scholarly,
evidence-based and best practice journal.
v  To discuss causes of increasing rates of antibiotic resistance.
v  Identify the differential diagnoses for dysuria.
v  To incorporate the current EBP guidelines recommended by IDSA into care decisions.
Acknowledgments v  To implement the first-line of treatment for uncomplicated UTIs.
v  To increase awareness of current EBP guidelines for treatment.
The Problem
v  Poor management of uncomplicated urinary tract
infections (uUTI) have resulted in an increase in
antibiotic resistance. There is a need to educate
providers about the use of EB guidelines to
manage women with (uUTIs)
I would like to express my deepest appreciation and gratitude to
my chair, Dr. Diane John for her unwavering support, patience,
words of encouragement, and guidance. This capstone project
would not have been possible without Dr. John. I have been
very fortunate to have you as my chair to guide me through this
journey.
Special thanks to my content expert, Dr. Sally Weiss, whose
suggestions and comments have been invaluable. Your
comments were of enormous help to me in developing my
continuing education module.
References
Implications for practice
v  Anticipated increased adherence to EBP
guidelines for practice.
v  Anticipated decrease in rates of antibiotic
resistance.
v  Anticipated decrease in healthcare expenditures
for patients and the healthcare system.
Synthesis of evidence
v Non-compliance among providers regarding adhering to EBP guidelines.
v Adherence to recommended EBP guidelines will reduce antibiotic resistance.
v Empiric treatment appears to be the norm for treatment of UTIs.
v Indiscriminate use of antibiotics affect everyone.
v The Infectious Disease Society of America has put forth the latest guidelines for appropriate treatment of UTIs.
v Prescribing etiquette is the tendency to follow precedence set by senior staff than EBP guidelines.
v Malcolm Knowles’ Adult Learning Theory was used to guide the development of this CE module.
Charani, E., Edwards, R., Sevdalis, N., Alexandrou, B.,
Sibley, E., Mullett, D., Franklin, B. D., & Holmes, A.
(2011, October 1). Behavior change strategies to
influence antimicrobial prescribing in acute care: A
systematic review. Clinical Infectious Disease, 53, 651-662.
Gupta, et al., (2011, March 1). International Clinical Practice
Guidelines for the Treatment of Acute Uncomplicated
Cystitis and Pyelonephritis in Women: A 2010 Update by the
Infectious Diseases Society of America and the European
Society for Microbiology and Infectious Diseases. Clinical
Practice Guidelines, 201, e103-120.
Hooten, T. M. ( 2012, March). Uncomplicated urinary tract
infection. New England Journal of Medicine. 366,
1028-1037.
Graphics were retrieved from
http://reasonablywell-julia.blogspot.com/
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http://www.glowm.com/resources/glowm/cd/pages/v2/
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