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BMJ Quality Improvement report
Reducing urinary tract infections in care homes by improving hydration
  1. Katie Lean1,
  2. Rasanat Fatima Nawaz1,2,
  3. Sundus Jawad3,
  4. Charles Vincent2
  1. 1Patient Safety, Oxford Patient Safety Collaborative, Oxford, UK
  2. 2Department of Experimental Psychology, University of Oxford, Oxford, UK
  3. 3Medicines Optimisation Team, NHS East Berkshire Clinical Commissioning Group, Windsor, UK
  1. Correspondence to Katie Lean; katie.lean{at}oxfordahsn.org

Abstract

Dehydration may increase the risk of urinary tract infections (UTIs), which can lead to confusion, falls, acute kidney injury and hospital admission. We aimed to reduce the number of UTIs in care home residents which require admission to hospital. The principal intervention was the introduction of seven structured drink rounds every day accompanied by staff training and raising awareness. UTIs requiring antibiotics reduced by 58% and UTIs requiring hospital admissions reduced by 36%, when averaged across the four care homes. Care home residents benefited from greater fluid intake, which in turn may have reduced infection. Structured drink rounds were a low-cost intervention for preventing UTIs and implemented easily by care staff.

  • antibiotic management
  • healthcare quality improvement
  • nurses
  • nursing homes
  • patient-centred care

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjoq-2018-000563

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    Footnotes

    • Contributors KL and SJ co-designed the project, delivered the training and aggregated the data. RFN analysed the data and took the lead in writing the manuscript. CV critically reviewed the manuscript and all authors contributed to the final version.

    • Funding This project was not funded by a specific grant as care homes were using existing resources. Health Education England have subsequently funded video clips to support the training for this initiative (https://www.youtube.com/watch?v=oY8m3bv2JDU).

    • Competing interests None declared.

    • Patient consent for publication Consent was gained from the care home managers for the use of anonymous data. Residents involvement was part of routine daily care.

    • Provenance and peer review Not commissioned; externally peer reviewed.