Stel, A. (Ashling) (2016) Urineweg infecties in het verpleeghuis: incidentie, diagnostiek & behandeling. thesis, Medicine.
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Abstract
Objective: The aim of this study is to investigate urinary tract infections (UTI’s) in nursing homes. This study will investigate the incidence, diagnostics and treatment of UTI’s. Methods: This study consists of a database research. UTI’s reported to the ‘Rijksinstituut voor Volksgezondheid en Milieu’ of the residents of Treant nursing homes in Emmen (the Netherlands) that occurred at the age of 65 years or older, without an indwelling catheter, were selected for the period week 32 2013 until week 32 2014. The incidence will be calculated in number of UTI’s per 1000 resident days of the total population. With the reported symptoms, results of leucocyte esterase tests and nitrite test of each UTI, each UTI will be examined if it fits the criteria for the diagnosis UTI according to the criteria used by the ‘Surveillance Netwerk Infectieziekten Verpleeghuizen’ (SNIV). Also the prescribed antibiotic treatment for each UTI will be evaluated for first choice treatment according to the ‘Nederlands Huisartsen Genootschap’(NHG) guidelines. Results: A total of 303 UTI’s were reported in 161 patients. This study found an incidence of 1.3 UTI’s per 1000 resident days for UTI’s without an indwelling catheter in the research year. Of de reported UTI’s 55,7% met the diagnostic criteria. Of the UTI’s that didn’t meet these 4 criteria, in 87,3% of the cases antibiotics were prescribed. Only in 12,7% no antibiotics were prescribed. In men 46,7% of the UTI’s got treated with an antibiotic of first choice according to the NHG guidelines. Of the UTI’s in women 62,2% got treated with an antibiotic of first choice. Conclusion: This study found an incidence of 1,3 UWI’s per 1000 resident days. A large portion of all reported UTI’s didn’t meet the criteria for a UTI according to the SNIV protocol. Furthermore in a lot of the reported UTI’s the prescribed antibiotic treatment wasn’t the first choice treatment according to the NHG guidelines. Recommendations: Our recommendation is a clear guideline for doctors in nursing homes for the diagnosis and treatment of UTI’s. Also we recommend extra training moments for nursing home doctors to educate and make them aware of the problem of overdiagnosis and overtreatment of UTI’s.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Afdeling: Huisartsgeneeskunde and Begeleiders: and Dekker, Dr. J.H. and Ament, dr. W. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:49 |
| Last Modified: | 25 Jun 2020 10:49 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/998 |
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