Abstract
This systematic review concentrates on essential evaluations of the strategy for preventing bladder infections in older individuals. To deal with the disease’s complexity, achieve positive patient outcomes, and meet their psychological demands, the article discusses improved scopes of care and preventative measures for these patients far beyond traditional treatment options. Even though there are many other possible causes, completely non-symptoms like disorientation are frequently assumed to be brought on by urinary tract infections (UTIs). This results in a large overdiagnosis of UTI, the misuse of antibiotics, and other adverse effects. Nursing home settings are where this issue is most common.
Introduction
A Urinary Tract Infection (UTI) shows an inflammatory process in the urinary tract without including kidney structure in the pathological process. UTI is widely spread among people of elderly age, both female and male, and they appear vulnerable to this disease due to various factors. There are anatomical and physiological changes in pelvic organs, incompetence of unary tract epithelial tissue, decreased gunk elaboration, and urinary and fecal incontinence. For this reason, this disease is more frequently seen in the geriatric population than in younger people.
Over 50% of senior citizens in the United States experience UTI (Reinberg, 2017). It was discovered that 25% of older people had moderate, severe, or very severe urinary leakage, and 50% had inadvertent bowel or urinary leakage (Reinberg, 2017). UTI is a prevalent condition that influences the social, emotional, physical, and economic well-being of the older population in the United States, according to the Centre for Disease Control and Prevention (CDC). According to the study, nearly 51% of seniors 65 and older who live at home reported having bladder abnormalities (Reinberg, 2017). 25% of males and 50% of women reported having bladder dysfunction, respectively (Reinberg, 2017). White women had almost twice as many bladder urinary infections as black women.
Age, race, and education did not significantly affect the rates of urinary retention among those receiving home health care. No matter where they lived, more than a half of patients receiving home health services reported experiencing trouble controlling their bladder. The researchers discovered that women receiving home health care were 1.7 times more likely than men to experience urinary retention (Reinberg, 2017).
The CDC points out that incontinence comes at a high cost. For instance, the projected cost of adult UTI in 2000 was $19.5 billion, and the projected value of UTI in 2010 was $4,100 per individual on average (Reinberg, 2017). The CDC’s Vital and Health Statistics for June included the National Center for Health Statistics analysis. To effectively manage and enhance the quality of life and overall health of older persons, this paper will emphasize techniques to avoid recurring UTIs by concentrating on UTI prevention.
Research Statement/ Topic
The main focus of this research is the study of methods of prevention of urinary tract infection and management in geriatric population. Moreover, the focus will be on the causes of this risk to the well-being of the population and its effects. Therefore, based on the information received, strategies that can help prevent an increase in the incidence of the disease and a negative impact on the quality of public health will be investigated.
“With the geriatric population being at high risk of contracting UTI, what are the factors causing UTI in the elderly? What are the effects of UTI in the geriatric population? What strategies can be used in preventing UTI in the elderly?”
Problem Statement
Residents in Nursing homes have various problems, beginning with asthma and finishing with brain activity problems. The latter appears to be especially dangerous for their health, as older adults tend to forget about essential care for their health. Apart from resistance to treatment and failure to take medications at the correct time, it also regards hygiene breaches. In addition, the changes in the body due to age make the senior population more vulnerable to developing UTIs.
UTI prevents patients from a decent lifestyle, as it is associated with numerous problems constantly. Vising a bathroom becomes a challenge for older people, which does not allow them to live full-fledged lives. Furthermore, it may result in issues with sleeping at night, which also implies negative consequences for the residents’ health. Urinary tracts are essential for the excreting process, and problems with them may result in various diseases. As for the Nursing Home staff, spreading UTI puts additional pressure on them, as patients require extra attention. Thus, the necessity to elaborate and implement sufficient measures to prevent and manage UTIs in the geriatric population is evident.
Purpose
The purpose of the current proposal is to provide the Nursing Home with practical strategies for preventing and managing UTIs in the residents, namely older adults. For this reason, research has to be conducted, which implies analyzing the efficiency of different approaches and medications. In addition, an implementation plan and evaluation criteria are also required to guarantee beneficial outcomes for the patients and their well-being.
Research Aims and Research Questions
The research has the following aims –
- To learn how to spot, avoid, and treat UTIs in the elderly.
- To recommend strategies that can be used in preventing UTI in the geriatric population.
- To provide the inhabitants of the nursing home, particularly the elderly, with practical methods for avoiding and treating urinary tract infections.
Three questions, as listed below, will guide the research process:
- What are the factors causing UTIs in the elderly?
- What are the effects of UTI on the senior population?
- What strategies can be used to prevent UTIs in the elderly?
Review of Literature
Recent research may contribute to providing essential information on UTI prevention and management. Sihra et al. (2018) have published research, “Nonantibiotic management and prevention of Recurrent Urinary Tract Infection,” which may be informative for elaborating on UTI prevention and management strategy. The authors focus on nonantibiotic measures, which can help address this disease (Sihra et al., 2018). They comprise dietary supplementation, intravesical glycosaminoglycan, behavioral changes, NSAIDs, probiotics, D-mannose, methenamine hippurate, vaccines, and inoculation with less-pathogenic bacteria estrogens, immunostimulants (Sihra et al., 2018). The study contains the evaluation of the trial results, which may be beneficial for implementing the effective measure for Nursing Homes in California.
It should be mentioned that the article contains some advice, which may not be suitable for older adults, so it is essential to cover only relevant ones. For instance, Sihra et al. (2018) propose dietary recommendations that will help address this issue. Sihra et al. (2018) highlight studies that discuss the benefit of adhering to adequate hydration and consuming vitamin C. Another approach implies phytotherapy, namely Chinese herbal medicine (CHM) and eating cranberry-containing foodstuffs.
Furthermore, some researchers observed by Sihra et al. (2018) provide evidence for the beneficial role of no steroidal anti-inflammatories in UTI inhibition. Consuming probiotics for achieving normal flora is also among the stratifies which may help treat this disease. Other proposals include D-mannose, though its use requires further research (Sihra et al., 2018). On the contrary, the positive result of applying methenamine hippurate has been proved in many cases. In addition, the article includes suggestions on using estrogens and intravesical glycosaminoglycans.
The option of immunostimulants and vaccines is also discussed in the study. However, it is impossible to make a precise conclusion in this regard. The reasons are “a lack of induction of antibodies in the bladder, the diversity of pathogens, and the desire to avoid inducing a pathological immune response to colonize bacteria in the gut” (Sihra et al., 2018, para 32). Furthermore, a lack of protective immunity for this inflection significantly limits vaccines’ development.
After reviewing the study, it is possible to conclude that the covered measures appear promising. Most of them have proof of their effectiveness in preventing or managing UTIs. Consequently, Sihra et al. (2018) advise applying the mentioned measures in combination to provide positive outcomes. As this topic has not been researched comprehensively, the implemented measures should be evaluated to understand their impact.
Causes of UTI in the Elderly
According to the Centre for Disease Control and Prevention, older people are susceptible to infections because of their weakened immune systems, deteriorating organ function, impaired sensory perception, use of several prescription and over-the-counter drugs, and concurrent conditions (Deac, 2020). Due to hospitalization or residence in long-term care facilities, the risk of infection is very significant for many older people. Urinary tract infections are the most typical infection in these hospitals. Most commonly, a urinary infection will damage the urethra or bladder; kidney pathogens are more dangerous. Urinary urgency or recurrences are possible signs, although other times there are none, and s staphylococci sepsis is the cause of this urine infection (Krocová & Prokešová, 2022).
Dementia, bowel and urine incontinence, and other impaired functioning might be present in asymptomatic people. As per Urinary Tract Infections in the Aged: Symptomology and Preventative measures, common symptoms of a urinary tract infection comprise dysuria, impetus, increased urination, flank discomfort, suprapubic irritation, fever, painful urination, pee that smells bad, and recent development of premature ejaculation.
A UTI is almost certainly caused by something that introduces germs into the urinary system or prevents urine from flowing normally and causes urine to collect in the bladder. Escherichia coli or E. coli bacteria are responsible for 85% of all UTI infections (Krocová & Prokešová, 2022). The remaining 15% of bacteria comprises various other bacterial species. However, E. coli is the most prevalent and has many entry points into the urinary system. E. coli can enter the urinary system because it usually exists where digestion takes place in the stomach tract. Since the urethra and anus are the beginning and terminus of the urinary system, respectively, this frequently occurs.
The anus and urinary tract are near one another, particularly in the female physique. According to CDC, poor cleanliness can lead to UTIs since the entrance and exit of the two routes mentioned above are close together (Deac, 2020). After a bowel motion, back-to-front wiping might introduce germs into the urethra (Krocová & Prokešová, 2022). Bacteria can enter the urinary system if dirty or throwaway underwear is worn for an extended period. In both situations, a bacterium spreads quickly and multiplies.
Definition and Classification of UTI
Cystitis, pyelonephritis, and other urinary system infections can all be treated as UTIs. The existence of a fever (febrile vs. non-febrile UTI), geographical location (lower against upper UTI), or the inclusion of variables that make individuals more susceptible to UTI or problems connected to UTI can all be used to classify it (complicated versus uncomplicated) (Malkin & Ross, 2020). Straightforward lower UTI is defined as cystitis in non-pregnant, post-menopausal women without known anatomical or functional malformations within the urinary system or multimorbidity that could make a person more susceptible to UTI or UTI-related complications. These definitions come from the Infectious Disease Association of America and the European Society for Cell Biology and Viral Infections.
Therefore, UTIs in men, patients with pertinent urogenital functional or anatomical malformations, those with indwelling urinary catheters, degenerative diseases, and other concurrent immunocompromising ailments, and those with UTIs fall under the category of complicated relatively low UTIs. The CDC claimed in 2011 that most UTIs are straightforward and that the commonly used definition of a complicated UTI includes many people who did not have an elevated chance of suffering a negative result (Deac, 2020).
According to the degree of clinical manifestations and the quantity and complexity of host risk variables for a negative outcome, they suggested a new categorization of UTIs, defining simple and complex (Malkin & Ross, 2020). Since most current recommendations limit their advice to uncomplicated UTIs, clinical practice must have a uniform and widely acknowledged categorization of UTIs. As a result, doctors may treat patients who come with what they consider to be a complex UTI following other standards. This covers all males and adults older than 65, according to The Infectious Disease Association of America’s recommendations, which may help explain some of the observed differences in prescribing practices for UTIs in this cohort (Malkin & Ross, 2020).
Signs and Symptoms of UTI in the Elderly
Identifying UTI signs in the elderly can be challenging since many have a behavioral impact, making them easy to ignore or mistake for symptoms of more severe infections. UTIs typically cause lower back discomfort, frequent urination, searing pain, murky urine, and these other traditional, universal symptoms. However, because older people’s body cells are not as effective as they once were, the sensations will change and have some disconcerting side effects. These adverse effects include confusion, bewilderment, agitation, diminished motor skills, dizziness, occasionally falling, and sadness.
Confusion
The elderly population’s bewilderment with UTIs appears to be directly related to the reality that they are, after all, an infection. Any illness will weaken the immune system, and older people often would not feel well when they have one. A fascinating 2009 piece in the leisure section of the British tabloid Express relates the tale of Susan, a mother and grandmother who is 69 years old yet active and competent (Kovalenko & Spivak, 2018). She had a headache one Friday night, forgot her initial name the next day, and could not fasten her clothes. Her daughter thought it might be a stroke because the change was too abrupt to be dementia, so she brought her mother to the clinic.
Susan misspoke when the staff inquired about her age and asked her to do some straightforward math questions. Given that Susan was typically an intelligent lady, this was concerning. Her chest x-ray, ECG, and CT scan were all performed by doctors without any positive results. When they finally offered her a urine test, it revealed a UTI! After receiving an antibiotic prescription, her symptoms completely subsided. Susan’s daughter questioned the physicians about why her elderly mother’s mild UTI was causing so much confusion. According to the experts, all infections result in dehydration, which impacts the medications elders take for various conditions (Kovalenko & Spivak, 2018). Additionally, any infection might raise body temperature and inflame the brain, altering one’s mental state.
Importance of Prevention of UTI
Older persons are much more affected by urinary tract infections (UTIs). UTIs are the second most common infection in older persons after respiratory problems. Finding UTIs in elderly people populations presents substantial hurdles, according to the Promoting Well-Being with Information & Supports report (Kovalenko & Spivak, 2018). It might be challenging to diagnose older adults with uncomplicated infections since they may not exhibit the more common UTI symptoms found in younger people. Catheterized older persons may also have distinct symptoms, making it more challenging to recognize these infections.
Some signs that could manifest might also be ascribed to dehydration, pharmaceutical changes, or other conditions. Along with difficulties in finding and diagnosing UTIs, it is crucial to consider the severity and long-term effects of infections. When UTIs go untreated, sepsis, a fatal infection spread throughout the body, can happen. This illness can have long-lasting impacts on patients and is quite expensive for the healthcare system. According to the American College of Preventive Medicine, preventive medicine is a branch of medicine emphasizing public health that is recognized by the American Board of Medical Specialties (ABMS) (Kovalenko & Spivak, 2018). Prevention of disease, disability, and death is the main objective of preventive healthcare.
Both money and lives can be saved through preventive medicine. As demonstrated by the COVID-19 pandemic, illness severity and long-term effects can be decreased by implementing preventative actions, such as adopting behaviors that lower the risk of viral transmission or organizing widespread vaccination drives. Women, in particular, are more likely than males to get recurring UTIs as they age (defined as two or more UTIs in six months). 10.5 million Outpatient appointments and 2-3 million trips to the emergency room were related to UTI recurrence in the USA alone in 2007 (Kovalenko & Spivak, 2018). A background of UTIs, diabetes, cognitive deficits, a handicap, frailty, urine dysfunction, and central nervous system bladder are some medical conditions for recurrent UTIs.
Prevention Strategies
Behavioral Changes
Numerous dietary, lifestyle, and activity adjustments can support the maintenance of a healthy bladder. While certain adjustments may not directly prevent UTIs, they improve bladder health, a crucial component of overall well-being. Healthy bladder practices can reduce the risk of infection and increase public and individual knowledge of the value of maintaining bladder health and getting medical attention if a problem does occur. Sitting comfortably in the restroom is crucial so your muscles can work as they should. One must give muscles enough time to unwind and the bladder enough time to empty (Kuroda et al., 2022). Long-term purposeful urine retention might encourage bacterial development in the bladder. This is crucial for older populations since bladder muscles and function may deteriorate or change with age.
Bowel health and consistency should be considered since, in older persons, constipation can occasionally be linked to difficulty emptying the bladder. Sitting comfortably in the restroom is crucial so your muscles can work as they should. One must give muscles enough time to unwind and the bladder enough time to empty. Long-term purposeful urine retention might encourage bacterial development in the bladder. This is crucial for older populations since bladder muscles and function may deteriorate or change with age.
Bowel health and consistency should be considered since, in older persons, constipation can occasionally be linked to the difficulty of completely emptying the bladder. In order to avoid UTIs, it is also advised that women pee after sex. In long-term care and medical settings, appropriate washing hands and sanitation routines are also helpful in avoiding UTIs. Wearing loose-fitting clothing and wiping from front to back after urinating, as recommended by Harvard Medical School, may also assist in avoiding UTIs; however, there is not much proof to back up these assertions (Kuroda et al., 2022). In addition, a typical and most common bladder-related problem is urinary incompetence (UI).
Some UI subtypes have a closer connection to UTIs. For instance, a UI that results in the inability to unoccupied the bladder may cause leftover urine, which increases the risk of UTIs. Both men and women who have incontinence might benefit from pelvic floor muscle-strengthening exercises. Lower levels of activity were linked to voiding problems. However, long-term, more centrist exercise was an efficient management strategy for incontinence. The pelvic floor muscle functioning may vary due to several high-impact sports (Kuroda et al., 2022).
When doing tasks where leakage frequently happens, such as coughing and sneezing, with more intensity, improved bladder muscle regulation can be used. The exercises have been demonstrated to reduce urinary frequency and urgency when combined with suppression techniques. Healthy bladder practices can reduce the risk of infection and increase public and individual knowledge of the value of maintaining bladder health and getting medical attention if a problem does occur.
Dietary Interventions
Fluid Intake
Some meals and beverages might aggravate the bladder and interfere with muscular control. Histamines, certain carbonated beverages, alcohol, and caffeine are all said to be best avoided since they might increase urination frequency and urgency. In the geriatric population, ingesting more than 1.5 liters of liquids can cut UTIs by over 50% (Calk et al., 2019). A person’s fluid consumption can impact absorbency, and there is a delicate balance between getting enough fluids and drinking too much, which can exacerbate bladder pressure, intensity, and recurrence of urinating.
Cranberry Products
Cranberry products are one of the senior population’s most widely praised preventative strategies against UTIs. Proanthocyanidins from cranberries (PAC) are thought to be able to stop germs from sticking to the bladder. Despite possible anecdotal support, there have been conflicting clinical findings supporting the effectiveness of cranberry products in treating bladder infections, particularly in the elderly. According to a 2014 study, cranberry juice may help lower the recurrence of UTI in slightly elevated patients residing in long-term care (LTC) facilities (AHRQ, 2014). Another study from 2016 indicated that cranberry supplements could help prevent recurrent UTIs; however, this study mainly focused on younger people.
It is necessary to comprehend the effects on older persons better. These trials all have different treatment regimens and lengths of time. According to recent research, people with neurogenic bladders cannot prevent UTIs using cranberry products (Calk et al., 2019). Products made from cranberries are considered safe and may enhance hydration, which is advantageous for preventing UTIs. Prior to cranberry products receiving a clinical prescription for the preventative measures of UTIs, it is evident that further study is still needed to evaluate better the dose, duration, and effectiveness in older adult demographics.
Other Interventions
Catheterization
Between 20 and 30 percent of all infections connected to healthcare are caused by catheterization. In places like hospitals or congregational treatment centers, where inhabitants and patients are already at increased infection risk due to characteristics linked to age, vulnerability, cognition, and health, elderly people populations frequently use catheters. Even though catheters are a crucial aid in voiding, there are methods for lowering the incidence of catheter-associated urinary tract infections (CAUTIs) (Fritsch et al., 2019.) Limiting the time a tube is used is the most successfully executed approach. According to a systematic study, CAUTIs may be decreased by good hand cleanliness, decreased catheter usage, shortened catheter dwell times, infection management, and enhanced employee training (Fritsch et al., 2019).
Because CAUTIs pose a severe danger to healthcare settings, more vital infection control protocols and programs, as well as adequate education and hand hygiene routines for staff, family members, and patients, can also reduce inflammation. Lastly, managing high CAUTI rates would benefit from more informed catheter usage decisions and catheterization education. According to research, when catheter protocols, early peripheral intravenous removal policies, and hand-washing compliance were implemented at a hospital, the frequency of CAUTIs decreased by 85% (AHRQ, 2014). Smaller and more securely fastened catheters that lessen urethral stress and restrict mobility may also aid in preventing CAUTIs.
Methodology
Methods and Materials
As mentioned above, none of the methods provides 100 percent effectiveness. However, the best outcomes may be achieved using sufficient combined measures. Considering the equipment and budget of the Nursing Home in California, there is a possibility of following dietary recommendations. In addition, there will be no difficulties with implementing phytotherapy (Cranberry pills or juice) and adhering to probiotics. Apart from this, it is recommended to apply methenamine hippurate, as a range of research has proved this approach. Therefore, a combination of these methods may be beneficial for preventing and managing UTIs among residents of the Nursing Home.
Moreover, as this topic requires further study, there is necessary to analyze the effect of implemented measures regularly. This should cover all nursing home residents, especially those who have already been diagnosed with UTI. They should receive a regular examination of their urinary tracts, and the results should be compared to trace the possible changes. Furthermore, the participants should respond to a set of questions to give some insights and clarify the impact of the provided care. If a respondent mentions the negative consequences of applied measures, the effect on other residents should be checked. Whether a sufficient number of patients within the Nursing Home prove the deterioration of their state or absence of changes, it is advisable to adhere to other methods. This way, it is possible to monitor the condition of patients with UTI and indicate the impact of particular approaches for preventing and managing this disease.
Identification of Data
Data identification is acknowledged as one of the fundamental methods for locating the appropriate source and type of data to be used in the research process. The data may be divided into primary and secondary depending on the source type. As implied by the name, primary data is referred to information that has been gathered directly by the researcher, as opposed to secondary data, which is information that has already been gathered (Urology Care Foundation, 2019). Both secondary and primary information may be employed in many circumstances to extract useful information, each with its advantages. For example, the source of information allows the researcher to shape the data to the research’s needs, but secondary data collection is more time- and money-efficient.
While secondary data may not always be appropriate for all types of study, the primary material is frequently victimized by a lack of resources and time. Despite individual advantages and disadvantages, the study reveals that the type of information to be utilized for the scientific method depends significantly on the nature and extent of the research issue. Currently, information from the available sources will be utilized to identify the causes of geriatric UTI, the consequences of the condition, and the preventative measures that can be taken to reduce UTI in older individuals (AHRQ, 2014). The evaluation will focus on the current material, which serves as a secondary source of information with the idea of methodical analysis at the forefront.
Data is again divided into two categories based on the information it contains: qualitative data and statistical measures. Like the data sources, each data type has unique benefits and drawbacks. For instance, data collected has the power and validity that other varieties of data lack, while qualitative information may elicit ideas and emotions (Urology Care Foundation, 2019). On the other side, qualitative data is subject to bias since the perception is in the hands of an investigator who may make false assumptions. Probability sampling is susceptible to mistakes and inconsistencies even if one little figure is entered wrong. The data type to be chosen depends on the nature of the study’s objectives and subject, just like the data sources. The contemporary research will employ qualitative and quantitative data to understand the causes of UTIs, their consequences on seniors, and the preventative measures that may be taken to avoid UTIs.
Study Population
Using a convenient sampling approach, all of the older persons’ health records from January 2014 to December 2018 (5 years) were examined (Urology Care Foundation, 2019). Patients under the age of 65, comprehensive clinical and medical data in the database and a verified UTI incident by the doctor were the categorical variables for the respondents (Urology Care Foundation, 2019). The study surveyed participants over 65, had inadequate records and lacked data on UTI bouts.
Participants
The research is necessary to understand the preventative techniques that can be utilized to combat the infection and the consequences of UTI on the elderly, as stated in the research concept. Even while the research might involve people, the earlier choice to adopt a systematic research procedure necessitates using data that has already been collected. As a result, participants are not required for the research at hand.
Approach
Procedure
A literature review requires gathering information on any topic from the body of existing literature. The search for finding statistical inferences on the study, which in turn seeks to ensure that the material was gathered and evaluated from reliable sources. This is the scenario in the current study, where a comprehensive review of the existing literature will be utilized to comprehend the causes of nursing burnout, its consequences, and the successful preventative measures nurses employ to combat burnout. The researcher established an inclusion/exclusion procedure to identify the data sources that would be most useful in addressing the study objectives.
A year-long inclusion criterion was established as a top priority. It was determined that the study publications should be printed between 2017 and 2022 to compile the latest information (Sihra et al., 2018). Advanced search engines were employed for statistics and information, including those from the CDC and state program health websites. Some research papers from other search engines, like Elsevier and Wiley Online Library, were incorporated to reduce research bias. The article’s accessibility as a genuine article—i.e., one published on the internet on its whole for any scholar to explore—was another critical inclusion criterion (Sihra et al., 2018). The publications’ English language proficiency was another requirement for inclusion. The integration criteria ultimately led to the creation of a collection of papers that would be utilized to address the research topics.
The search terms used to find the articles were another notable detail. UTI prevention in the Aging population was the most popular search done across all the search engines to discover the most published information (AHRQ, 2014). In addition, the keywords “effects,” “factors contributing towards,” and “preventive strategies” were incorporated into the primary keyword to help researchers locate articles that discussed the causes of UTI in the elderly, its effects, and the preventive measures that nurses can take to combat the condition.
Evaluation
To improve the effectiveness of applied measures, it is vital to establish appropriate evaluation criteria for monitoring success. The results of examinations may be helpful in this regard. As for the residents not diagnosed with UTI, the positive outcome for them is total prevention of the disease development (Ly & DeLisi, 2017). In the case of residents with UTI, the examinations should prove positive changes. In addition, patients should notice pain relief and the absence of some symptoms. These two signs may be explanatory of the success of implemented methods. In the long run, the absence of reoccurring cases may also indicate the chosen measures’ positive dynamics and positive impact.
Findings
Descriptive Statistics
Statistical analyses were performed with the help of SPSS version 24 (Urology Care Foundation, 2019). The chi-square test was used to compare the results of treating UTIs with categorical factors, and a p-value of 0.05 was deemed significant (Urology Care Foundation, 2019). The sequential variables’ proportions were provided (percentages). With 95% confidence intervals (CI), adjusted odds ratios (OR), and p-values (p 0.05), binary and multivariable regression modeling were used to assess the correlation between each self-governing variable and the therapeutic results (Urology Care Foundation, 2019). The results of the MRCI were studied as the dependent variable.
Conclusion
Older people are susceptible to dangerous illnesses such as urinary tract infections. The utilization of behavioral, medicinal, and non-pharmaceutical treatments to enhance bladder health is highlighted in this research. There is a study deficit; thus, further studies are needed with senior citizens living in the community and establishments. The healthcare systems and the quality lifestyle for persons who get UTIs can be improved by better knowledge of preventative strategies and how they affect the geriatric population.
The best strategy to avoid UTIs in seniors is much the same as for everyone else. By staying well-hydrated, one may wash germs out of the bladder and urinary system before they have a chance to establish themselves. It will not be easy to go too far without passing urine. Undiagnosed and undiagnosed infections in the urinary tract can spread throughout the body and pose a significant health risk, making UTIs more than just painful medical problems. Knowing how to prevent UTIs in older family members is one problem, but being able to recognize the symptoms of infection is another. This is especially true if one does not live near enough to check in often.
Strength and Research Limitations
The methodological rigor of this review is primarily responsible for its strengths. This made it possible to identify studies that were typical of the senior population and did not specifically seek to report the association between disorientation and UTI (Turan et al., 2019). Implementing a procedure with pre-established objectives and procedures was another area of this review’s strength. A second reviewer who independently rates the quality of a few chosen papers also improves the review’s quality. The articles must only be in English, and it was impossible to determine whether or not the unavailable complete texts qualified. Additionally, this study did not try to incorporate research from the unwritten literature, which might have introduced biasness.
Ethical Considerations
The National Institute of Health and Medical Research and Ethics Committee, Malaysia, examined and authorized research projects that involve human subjects (NMRR-19-1037-46721). In compliance with national law and institutional standards, written informed permission was not needed for the study’s participants.
Audience
The proposal aims to target Nursing Home staff, as this profession requires an in-depth understanding of specific and widespread health problems among older people. Their responsibilities involve providing residents with all the possible measures for maintaining and improving their health. Furthermore, health providers are considered to contribute to findings satisfactory solutions for the diseases of the residents. For this reason, this proposal is highly likely beneficial for them, helping them fulfill their working duties and providing competent care.
Implementation Plan
First of all, before implementing the measures mentioned in the previous section, it is vital to conduct a complete examination of the nursing home residents (AHRQ, 2014). The number of patients diagnosed with UTI and their health state should be registered. This will help monitor the results of the applied measures, possible improvements or deterioration, and recent supplement research on this topic.
Secondly, the dietary recommendations should be discussed with kitchen managers and cooks. As the advice on eating habits is simple, implementing this method in the daily menu will not present a problem (AHRQ, 2014). This measure will allow residents without UTIs to prevent the development of this disease. Moreover, it will be helpful for patients who already have urinary tract problems. Patients diagnosed with UTI should be warned of the necessity of adhering to a diet to improve efficiency. Phytotherapy and probiotics should also be supplied for all the residents of the Nursing Home.
As for methenamine hippurate, it is recommended to use it as a part of the treatment plan for patients with UTI. In combination with adherence to dietary recommendations and phytotherapy, it is highly likely to supply positive outcomes and contribute to relieving the problem. Apart from the discussed methods, it is essential to examine urinary tracts regularly to trace the changes. This way, the current implementation plan will effectively prevent and manage UTIs.
References
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