Prevalence of undiagnosed urinary tract infections on admission to a rehabilitation unit

Matthews, Shaun, Barnard, Alan, McMillan, Renee, Spreadborough, Trish, & Horton, Eleanor (2013) Prevalence of undiagnosed urinary tract infections on admission to a rehabilitation unit. Journal of the Australasian Rehabilitation Nurses' Association, 16(3), pp. 7-11.

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Abstract

Background

Through clinical observation nursing staff of an inpatient rehabilitation unit identified a link between incontinence and undiagnosed urinary tract infections (UTIs). Further, clinical observation and structured continence management led to the realisation that urinary incontinence often improved, or resolved completely, after treatment with antibiotics. In 2009 a small study found that 30% of admitted rehabilitation patients had an undiagnosed UTI, with the majority admitted post-orthopaedic fracture. We suspected that the frequent use of indwelling urinary catheters (IDCs) in the orthopaedic environment may have been a contributing factor. Therefore, a second, more thorough, study was commenced in 2010 and completed in 2011.

Aim

The aim of this study was to identify what proportion of patients were admitted to one rehabilitation unit with an undiagnosed UTI over a 12-month period. We wanted to identify and highlight the presence of known risk factors associated with UTI and determine whether urinary incontinence was associated with the presence of UTI.

Methods

Data were collected from every patient that was admitted over a 12-month period (n=140). The majority of patients were over the age of 65 and had an orthopaedic fracture (36.4%) or stroke (27.1%). Mid-stream urine (MSU) samples, routinely collected and sent for culture and sensitivity as part of standard admission procedure, were used by the treating medical officer to detect the presence of UTI. A data collection sheet was developed, reviewed and trialled, before official data collection commenced. Data were collected as part of usual practice and collated by a research assistant. Inferential statistics were used to analyse the data.

Results

This study found that 25 (17.9%) of the 140 patients admitted to rehabilitation had an undiagnosed UTI, with a statistically significant association between prior presence of an IDC and the diagnosis of UTI. Urinary incontinence improved after the completion of treatment with antibiotics. Results further demonstrated a significant association between the confirmation of a UTI on culture and sensitivity and the absence of symptoms usually associated with UTI, such as burning or stinging on urination. Overall, this study suggests careful monitoring of urinary symptoms in patients admitted to rehabilitation, especially in patients with a prior IDC, is warranted.

Impact and interest:

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ID Code: 69032
Item Type: Journal Article
Refereed: Yes
Additional URLs:
Keywords: urinary incontinence, urinary tract infection, undiagnosed urinary tract infection, rehabilitation unit, incidence, prevalence, observation
ISSN: 1440-3994
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000) > Clinical Nursing - Tertiary (Rehabilitative) (111004)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Nursing
Copyright Owner: Copyright 2013 Australasian Rehabilitation Nurses' Association
Copyright Statement: Copyright of Journal of the Australasian Rehabilitation Nurses' Association (JARNA) is the property of Australasian Rehabilitation Nurses' Association (ARNA) Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.).
Deposited On: 24 Mar 2014 00:50
Last Modified: 25 Mar 2014 00:19

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