UTI in a Nursing Homes
Nursing home patients are especially vulnerable to developing urinary tract infections (UTIs) needlessly. Poor hygiene, improper catheter maintenance, and a lack of staff coordination and communication can all lead to an increased risk of infection.
Unfortunately, many of these infections can be prevented if staff members pay close attention to each resident's living environment and take necessary steps to avoid cross-contamination.
Failure to do so can cause UTIs to develop needlessly, leading to increased medical costs, discomfort, and even more severe infections.
Did you suffer a preventable UTI while in a nursing facility? The personal injury attorneys at Rosenfeld Injury Lawyers, LLC advocate for elderly residents harmed when the nursing home fails to follow established standards of care.
Contact a nursing home abuse lawyer at (888) 424-5757, use the contact form for additional information and answers, or schedule a free consultation to discuss your case. All confidential or sensitive information you share with our legal team remains private through an attorney-client relationship.
What is a Urinary Tract Infection?
UTIs are a common problem among the elderly and can be caused by various bacteria. Urinary tract infections may be hidden by other ailments such as:
- Ovarian cysts
- Yeast infections
- Bladder infection
- Lyme disease
- Renal failure
Common symptoms include:
- Burning during urination
- Pain in the lower abdomen or groin area
- Frequent urge to urinate
- Fever and chills
- Cloudy urine
- Strong-smelling urine
- Nausea and vomiting
- Lower back pain
- Urine retention
- Suprapubic pain
- New or increased incontinence
- Positive urine culture
There are many UTIs, but the source is the same: bacteria entering and infecting the urinary system. The most common point of entry is the urethra. Infection of the bladder is typically caused by Escherichia coli (E.coli).
A urine specimen test result can identify what type of antibiotic will best kill the bacteria, whether it is Escherichia coli or another. Caregivers need to recognize the signs of a UTI in their elderly patients so they can seek treatment quickly.
It is also important for caregivers to ensure that elderly individuals are drinking plenty of fluids to help flush out the bacteria. Also, proper hygiene and regular catheter changes can help reduce the risk of a urinary tract infection in nursing facility patients.
Urine cultures diagnose UTIs in the elderly and determine which type of antibiotic will work best for killing the bacteria. It is essential to seek medical attention if you experience any of these symptoms, as they could indicate a UTI.
Urinary Tract Infection (UTI) Causes in Nursing Home Residents
Various factors can cause a UTI. Aging adults are more prone to developing UTIs due to weaker bladder tissue and difficulty emptying the bladder, which leaves residual urine in the bladder.
Senior residents rely on caregivers and healthcare providers for hygiene, nutrition, and symptom checking. If a nursing home fails or neglects to help a nursing home resident use the bathroom or change their diaper when needed, the resident may develop a UTI.
Other causes of UTIs may include the nursing home failing to:
- Monitor specific antibiotics
- Ileostomy bags being left too long before emptying
- Incontinence pads not being changed often enough
- Physical restraints used for too long
- Not drinking enough fluids
National UTI Studies
UTIs are a common and serious health concern for elderly nursing home residents. According to the National Institute of Health, over a quarter million UTIs occur annually in nursing facilities.
When treating pyuria or asymptomatic bacteriuria, it is essential to avoid the overuse of antibiotics. Doing so can help prevent antimicrobial resistance, increase healthcare costs, and extend hospital stays.
Additionally, a study conducted in a Veterans Administration Hospital reported increased patient satisfaction with condom catheters compared to indwelling catheters, as they were perceived to be less painful and restrictive.
On the other hand, nursing staff respondents believed that the first fell off, leaked more often, and required more nursing time than an indwelling urinary catheter.
Risk Factors for Urinary Tract Infections in Nursing Homes
Elderly people in nursing homes are at a greater risk of developing urinary tract infections due to various factors. These include lack of physical activity, mental stimulation, nerve damage or paralysis, and using an indwelling catheter.
It is vital to ensure that elderly people in nursing care homes receive adequate care to prevent the development of recurrent urinary tract infections. Individuals at greater risk of developing a UTI in a nursing home have various conditions and scenarios, including:
- Urologic abnormalities
- Prostate disease
- Those using an external catheter for urine drainage
- Residents taking drugs that exacerbate chronic genitourinary symptoms
- Women with estrogen deficiency impact the vagina's protective bacterial colonization
- Residents with indwelling urinary catheters
- Post-menopausal women
- Men and women with urinary incontinence
- Those with dementia and urinary/fecal incontinence
Other diseases can mimic UTI bacterial infection symptoms in nursing homes, so it is essential to seek medical advice if symptoms arise.
Nursing home residents with a prior history of symptomatic urinary infection are at greater risk of developing a UTI.
How to Identify Urinary Tract Infection Symptoms
Urinary tract infections are a common and potentially severe health issue that can cause pain, discomfort, and other symptoms. Be aware of the signs and symptoms of UTIs so they can be identified and treated quickly.
Common symptoms of a UTI include:
- A constant need to urinate
- Cloudy urine with an unusual odor
- Blood in the urine
- Urinary retention
During a physical exam, look for purulent discharge from the urethra in both men and women. In men specifically, look for tenderness in the prostate.
Urinary Tract Infections in Older Adults
Urinary system infections are a common problem among elderly adults, especially those in long-term care facilities. Nursing homes are a breeding ground for UTIs due to poor hygiene and limited bathroom access.
Factors that increase the likelihood of UTIs in nursing home residents include:
- Catheter use
- Co-existing medical conditions
- Cognitive illnesses
- Weakened immune systems from aging
If left untreated, UTIs can lead to long-term complications such as narrowing of the urethra in men, blood poisoning, permanent kidney damage, and recurrent infections.
Laboratory Confirmation of Suspected Urinary Tract Infections
Laboratory confirmation is essential in diagnosing urinary tract infections. Urine sample testing has a negative predictive value of 100% but a positive predictive value of 45%.
It can accurately identify those without UTIs but not always those with them. Alternate methods, such as biomarkers, are being investigated to diagnose UTIs in a nursing home resident. Establishing a new gold-standard diagnostic test would be useful for clinical practice and research involving clinical prediction models.
Symptomatic UTI Laboratory Tests
Healthcare providers should conduct routine checks to detect the presence of UTIs. When UTI is suspected, laboratory tests such as urine culture, leukocyte esterase dipstick or urinalysis, and blood culture should be conducted.
CT scans may also be ordered to exclude obstruction and other kidney problems if a co-existing risk factor is suspected. Acute dysuria and pain were the only significant predictors of a confirmed UTI.
Causes of Urinary Tract Infections in Nursing Homes
Urinary tract infections in nursing homes are a common and potentially dangerous health risk for the elderly. Factors that increase the likelihood of UTIs in nursing homes include catheter use, co-existing medical conditions, cognitive illnesses like dementia, and weakened immune systems from aging.
If left untreated, UTIs can cause long-term complications such as a narrowing of the urethra in men, blood poisoning, permanent kidney damage, and recurrent infections.
Nursing homes must take extra precautions to prevent UTIs from occurring among their residents. It includes regular monitoring for signs of infection and providing adequate hydration and nutrition to help boost immunity.
Is UTI Preventable?
A urinary tract infection (UTI) is an infection of the bladder, urethra, or kidneys. It is not 100% preventable, but some steps can be taken to reduce the chance of developing a UTI or for an existing UTI to worsen.
Urinary tract infections in nursing homes are not usually due to a bladder problem like an overactive bladder or incontinence. Nursing home caregivers should ensure that residents drink the right amount of water and wipe appropriately after using the restroom. Additionally, they should change diapers and check catheters regularly to prevent bacteria from spreading.
An infected catheter or fecal material entering the urethra can also cause a UTI. Therefore, nursing home caregivers must take all necessary precautions when caring for residents with these conditions.
UTI Intervention Treatment
Treating urinary tract infections (UTIs) in a nursing home requires a comprehensive approach, including:
- Antimicrobial prescriptions with antibiotic/anti-infection agents
- Prophylactic antibiotics
- Supportive therapy for fever, confusion, and dehydration
- Nonpharmacologic treatments such as massage, relaxation, and distraction reduce pain
If the nursing home patient is left untreated, they might develop stronger infections and sepsis. Septic shock follows sepsis, causing a dangerous drop in blood pressure and death.
UTI Lawsuit Due to Dirty Catheter
A catheter-associated urinary tract infection (CAUTI) is a severe health concern for a nursing home resident. These infections can be caused by negligence on the part of the nursing home staff, such as not regularly cleaning the catheter or emptying the catheter bag.
According to the Infectious Diseases Society of America ( IDSA ), a build-up of urine can also cause numerous conditions, including:
- CAUTI in the urinary catheter
- Blockage in the catheter
- Uncorrected twisted or kinked catheter
- Misplaced catheter bag
- Infectious diseases introduced into the catheter by dirty hands
If any of these cause a CAUTI in the urinary system, one must question whether it could have been prevented by staff.
Hire a Personal Injury Attorney to Resolve a Urinary Tract Infection Compensation Case
Physicians and nursing home staff must recognize many obvious symptoms and signs of patients displaying UTIs. Frequently, UTI treatment requires antibiotic medications to stave off bacteria.
The patient might require a regimen of medications taken until the UTI clears. In some incidences, the urinary tract infection is so severe that it requires hospitalization until the condition is resolved.
If a loving family member suffers a catheter injury or urinary tract infection, contact the Rosenfeld Injury Lawyers, LLC offices at (888) 424-5757 or use the contact form.
Our experienced nursing home lawyers can evaluate the case and discuss legal options for stopping the abuse and neglect of a loved one in the nursing home.