Wisconsin Long-Term Care Urinary Tract Infection (UTI) Toolkit

Developed by the Wisconsin Healthcare-Associated Infections in Long-Term Care Coalition, the objectives of the Wisconsin UTI Improvement Toolkit are to help long-term care facilities:

Standardize the assessment and communication of findings in residents experiencing a change-in-condition where UTI is suspected.
Promote the use of active monitoring and delay of urine testing and antibiotic treatment among residents where the risk of UTI is low.
Promote the appropriate use of antibiotics (drug, dose, duration) in residents where the risk of UTI is high.

Module 1: Overview and Rationale
This module is organized into three sections. Each section includes a slide deck presentation.

Section 1 provides the background and overview of the Wisconsin Urinary Tract Infection (UTI) Toolkit.
Section 2 describes the clinical rationale for antibiotic stewardship.
Section 3 provides an overview of related regulatory information.

Module 2: How to Prevent Catheter-Associated Urinary Tract Infection (CAUTI)
This module is organized into three sections. Each section includes a slide deck presentation.

Section 1 provides the background and risk factors for indwelling urinary catheter use and CAUTI.
Section 2 describes appropriate indications and alternatives for indwelling catheter use.
Section 3 provides information about indwelling catheter insertion and maintenance and includes links to additional resources, as well as a complete reference list is at the end of the module.

Module 3: When to Test a Urine Specimen
This module is organized into four content sections. Each section includes a slide deck presentation. Additional links and resources are also provided. A complete reference list is included at the end of the module.

Section 1 provides a discussion about urinary tract infections, definitions and signs/symptoms.
Section 2 is an instructive session for nursing home UTI management champions in preparation to educate staff, including an introduction to the UTI Stoplight Tool and When to Test Urine-Nursing Tool.
Section 3 provides practical application of the When to Test Urine-Nursing Tool to seven case studies.
Section 4 provides a suggested educational plan for integrating the tools and resources.

Module 4: When & How to Treat a UTI
This module is organized into four content sections. Each section includes a slide deck presentation. Additional links and resources are also provided. A complete reference list is included at the end of the module.

Section 1 provides a discussion of the clinical decision about when to treat a suspected urinary tract infection and the five moments of antibiotic decision-making.
Section 2 presents basic principles related to initiating treatment, along with guidance about empiric treatment of uncomplicated and complicated urinary tract infection.
Section 3 reviews opportunities to modify existing antibiotic therapy and reviews antibiotic timeout.
Section 4 provides an overview of the collaborative role of the pharmacist in antibiotic stewardship, along with sample documents related to a Collaborative Practice Agreement.

Module 5: Implementing and Sustaining Change
This module includes additional presentations, tools and other resources to improve the management of suspected UTIs in your nursing home.