Prevention of UTI in Elderly

Prevention of UTI in Elderly

Research Problem

Recurring urinary tract infections are a high prevalence in adults than it is in children due to the long-term use of antibiotics in adults.  According to Feng and Hokanson (2018), at least one out of three older women experience UTI leading to hospitalization. They include pregnant women, postmenopausal women, and catheter patients. Besides, the increased hospitalization for older adults and women with frequent UTI also leads to increased costs of healthcare as the cost estimates to almost $2.8 from 1998 to 2011 (Feng & Hokanson, 2018).  A bacterium called E.coli is often the cause of UTI, and other factors include the genetic and biologic risk factors like the compromised immune system of the patient.  It is also quite challenging to distinguish between the asymptomatic bacterium and symptomatic urinary tract infection in adults. Several diagnosis and treatment guidelines have been developed to help in the treatment of UTI. However, there is a lack of a single evidence-based approach used for the prevention of UTI in the elderly. It is, therefore, essential to analyze various options available that could ultimately contribute to the prevention of UTI in the elderly.

Concept to be Studied

The research will focus on alternative prevention strategies other than the use of antibiotics to prevent UTI in the elderly (Feng & Hokanson, 2018). The focus of the study will be the prevention of UTI.  It is critical to determine if complementary and alternative medicine (CAM) could lead to the prevention of UTI in the elderly. Management of asymptomatic and non-asymptomatic bacterium, as well as the prevention of catheter-associated urinary tract infections, could also contribute to the prevention of UTI in the elderly. The majority of older adults are at risk of recurring UTI, and this leads to the increased cost of healthcare (Duncan, 2019). Therefore, it is essential to assess the effectiveness of alternative treatment methods of UTI in the elderly.

Literature Review

The analysis of various studies by Duncan (2019) focused on the alternative strategies to antibiotics use for managing the asymptomatic and the non-asymptomatic bacteriuria in the elderly.  Duncan assessed different alternative methods of managing recurring UTI. The researcher found out that the majority of individuals with recurring urinary tract infections frequently use antibiotics as a form of medication. However, the increased side effects of antibiotic use and antibiotic resistance have led to increased challenges for providers as they have to research current and appropriate treatment options for UTI patients. According to Duncan (2019), inappropriate prescription of antibiotics results in several complications for UTI patients as they continue to use antibiotics even when they do not have the infections and thus develop antibiotic resistance. Therefore, there is a need to prevent UTI, thereby reducing the side effects of antibiotics used and the rates of hospitalization.

The researcher highlighted the previous studies on alternative methods of preventing recurring UTI, and they included the use of cranberry products and D-mannose. However, he also emphasized that there was a lack of positive research on the use of cranberry products to prevent recurrent UTI. On the other hand, D-mannose has been recommended as an alternative antimicrobial to treat UTI. Therefore, there is a need to conduct further research on the use of cranberry products as an alternative treatment for UTI in the elderly.

Feng and Hokanson (2018) also researched on the alternative treatment options for recurrent UTI. The researchers also found out that one of the approaches towards preventing UTI in the elderly is through the use of complementary and alternative medicine therapies. CAM has been incorporated in modern medical practices, and they include manual healing, the use of natural products as well as the practices that engage the mind, body, and the spirit.

Most of the natural therapies used intend to promote effective management of recurrent UTI. It is crucial to note that at least 60% of women develop recurrent UTI three months after they have been discontinued from the prophylactic antibiotics (Feng & Hokanson, 2018). Therefore, they need to reduce the impacts of antibiotics used and the cost incurred for hospitalization. The researchers also validated the inefficiency of cranberry products to prevent recurring UTI since they found contradicting results. Some studies mentioned that the use of cranberry had been accepted as one of the natural methods of reducing the risk of recurrent UTI, while some did not (Feng & Hokanson, 2018). Therefore, it is essential to evaluate the efficiency of cranberry juice and other cranberry products to determine if it could be a recommended method of preventing UTI in older adults.

The researchers also confirmed that another natural therapy for the prevention of UTI is the use of D-Mannose, which is a natural sugar that prevents the hinder growth of bacteria on the line of the urinary tract, thereby eliminating E.coli (Feng & Hokanson, 2018). This strategy can lead to the prevention of UTI in the elderly as the E.coli is the bacteria associated with UTI. Manual healing, like acupuncture, also prevents recurrent UTI in older adults. Acupuncture contributes to reduced volume of urine for chronic urine retention, thus leading to reduced recurrent UTI. Older adults can also engage the body, the mind, and the spirit through massage and touch therapies and yoga to enhance their well-being and thus preventing UTI (Feng & Hokanson, 2018). It is crucial to conduct further research on the alternative methods of preventing recurring UTI since frequent use of antibiotics contributes to increased side effects on an individual and the increased healthcare cost.

According to Mavin and Mills (2015), it is possible to prevent catheter-associated urinary tract infections as long as there is improved use of qualitative methods. It entails the implementation of the CAUTI prevention strategies that will enhance patient experience and patient care outcomes. Mavin and Mills (2015), confirms that numerous CAUTI prevention strategies have proven to be effective, and thus its implementation will contribute to the prevention of UTI in the elderly. Methods of reducing CAUTI should not only incorporate the teaching of the providers and the patients but also avoiding the unnecessary use of the UUC and the use of alternative devices for urine continence (Mavin &Mills, 2015). Care providers should also strictly follow the evidence-based practices for inserting, maintenance, and the removal of UUC.

Purpose of Statement

Recurrent UTI has been considered one of the reasons for the long-term, prescription, and the use of antibiotics by older adults. They continue to use antibiotics even when they no longer have the UTI and thus lead to increased side effects and antibiotic resistance, thereby contributing to increased challenges for providers as they have to research current and appropriate treatment options for UTI patients.  At least 20% of women are likely to have UTI throughout their life, and this value could even be higher than 33% (Duncan, 2019). Recurring UTI leads to not only increased hospitalization but also the cost of healthcare, thereby affecting the elderly with UTI and the healthcare sector.

Individuals may also use antibiotics without undergoing the necessary and appropriate diagnosis process. A significant number of patients diagnosed with UTI have a urethral urinary catheter (UUC) at least seven days before they get the infection. The CAUTI also led to the developing patient sepsis and an increased mortality rate by almost 30% (Mavin &Mills, 2015). These results indicate that older adults with UUC are at risk of developing UTI.  It is essential to assess the effectiveness of various alternative strategies that will contribute to the prevention of UTI in the elderly.

Research Questions

Does the prolonged use of antibiotics in treating UTI lead to resistance of antibiotics and side effects?

Are there alternative strategies to treat UTI in the elderly?

What is the effectiveness of the alternatives to antibiotics in the prevention of UTI in the elderly?

Research Design

The research design highlights the various approaches to preventing UTI in the elderly. One of the alternative prevention strategies is the use of CAM, and it may lead to the prevention of UTI in the elderly (Feng & Hokanson, 2018). The prevention of catheter-associated urinary tract infections could also contribute to the prevention of UTI in the elderly. This research assesses the effectiveness of alternative treatment options for antibiotics. The use of D-mannose quality improvement strategies in CAUTI would be effective in preventing UTI in the elderly. However, it is necessary to research further on the use of cranberry products as an alternative to antibiotics and prevent UTI in older adults. The efficiency of alternatives to antibiotics will be analyzed using qualitative analysis from the results of the previous studies. The study will focus on how to prevent UTI from using alternatives to antibiotics.