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Appendix E: Continued
Core Element Description Examples
5. Tracking Monitor at least
one process
measure and one
outcome measure
of antibiotic use at
your facility.
• Determine how often nursing staff and
prescribing clinicians document signs and
symptoms that localize to the genitourinary
tract for residents diagnosed with a UTI.
• Assess the antibiotics and length of therapy
prescribed for residents diagnosed with a
UTI.
• Track the rate of UTIs per 1,000 resident
days or the rate of CAUTIs per 1,000
catheter days.
6. Reporting Provide regular
feedback on
antibiotic use
and resistance
to prescribing
clinicians, nursing
staff and other
relevant staff.
• Report how often residents who are
diagnosed with a UTI:
▶ Had documentation of signs and
symptoms that localize to the
genitourinary tract in their medical
record.
▶ Received an antibiotic and length of
therapy concordant with your facility's
policy and procedure.
• Share graphs of the rate of UTIs per 1,000
resident days with nurses (at morning
report or stand-up), prescribing clinicians,
the Quality Assurance and Performance
Improvement team members and the
resident and family council. Provide context
to help explain changes in rates, such as a
new policy or educational intervention.
7. Education Provide resources
to prescribing
clinicians, nursing
staff, residents and
families about
antibiotic resistance
and opportunities
for improving
antibiotic use.
• Provide an in-service for nursing staff about
asymptomatic bacteriuria. Include materials
they may share with residents and families.
Repeat this at least annually.
• Incorporate "fast facts" about UTIs into
staff meetings or emails shared with
prescribing clinicians.
• Use the reports about UTI metrics as
a chance to remind stakeholders about
diagnostic criteria for UTI or interpretation
of urine culture results.
Source: Ashraf MS et al. Diagnosis, Treatment, and Prevention of Urinary Tract Infections in Post-
Acute and Long-Term Care Settings: A Consensus Statement From AMDA's Infection Advisory
Subcommittee. J Am Med Dir Assoc. 2020 Jan;21(1):12-24.
