Help! UTIs in LTC

Two important factors are hygiene and hydration. I have worked in LTCs and no one seems to consider the importance of these factors. People who feed the residents need to give the residents more liquids, one cup of liquid per meal is not enough. Also, residents need to have perineal care on a regular basis.

When I worked LTC we had a pretty good prevention model for pressure wound prevention. In fact most of the wounds we encountered were acquired in the acute hospital prior to admission to LTC. The wound doctor who made rounds once a week said that turning and repositioning were only a small part of the battle. Would happens due to poor positioning and acute weight loss which results in protein catabolism. So along with turning we used, skin conditioning with moisture resistant barrier creams and protein, vitamin and mineral supplementation ( C, A, Zinc) and a high protein diet if the patients renal system could support it. Medicare will only cover a low air loss mattress if the wound is stage 4.

As for UTI's that's a whole other conundrum proper hydration and hygiene seem to be the keys.

Some patients just seem to get them more often for no apparent reason. One doctor told me that the use of calcium carbonate (TUMS) for GERD causes the urine to become more alkaline which allowed for greater concentrations of bacteria especially ESBL (The new MDRO on the block).

As with all things Hand washing has been shown to be the best prevention against the spread of infection. The infection control nurse at our facility recommends it over alcohol based hand gels because she said CDC shows many organisms especially Viruses and spore producing organisms are immune to it. Haven't done my own research on this just repeating what was reported to me.

Hppy