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Long-Term Care Survey Alert

Survey Guidance:

Read The Signs To Diagnose And Treat UTI

Published on Sat Aug 27, 2005

Follow the F315 diagnostic roadmap.

You can't cure what you don't detect. And you don't want to over treat urinary symptoms that aren't infection, a   practice that breeds antibiotic resistance. The revised F315 survey interpretive guidance notes that because many residents have chronic bacteria in their urine, the research-based literature suggests treating only symptomatic UTIs. Symptomatic UTIs encompass the following criteria, according to the survey guidelines: 

Residents without a catheter should have at least three of the following signs and symptoms:

  •  Fever (increase in temperature of >2 degrees F (1.1 degrees C) or rectal temperature >99.5 degrees F (37.5 degrees C) or single measurement of temperature >100 degrees F (37.8 degrees C) );

  •  New or increased burning pain on urination, frequency or urgency;

  •  New flank or suprapubic pain or tenderness;

  •  Change in character of urine (e.g., new bloody urine, foul smell, or amount of sediment) or as reported by the laboratory (new pyuria or microscopic hematuria); and/or

  •  Worsening of mental or functional status (e.g., confusion, decreased appetite, unexplained falls, incontinence of recent onset, lethargy, decreased activity).

    Residents with a catheter should have at least two of the following signs and symptoms:

  •  Fever or chills;

  •  New flank pain or suprapubic pain or tenderness;

  •  Change in character of urine (e.g., new bloody urine, foul smell, or amount of sediment) or as reported by the laboratory (new pyuria or microscopic hematuria); and/or 
     
  •  Worsening of mental or functional status. Local findings such as obstruction, leakage, or mucosal trauma (hematuria) may also be present.

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