Document Type

Doctoral Project

Publication Date



This evidence-based clinical change project addressed the clinical problem trigger of increased rates of urinary tract infections and related unplanned discharges in a rural Ohio nursing center. The clinical change involved the implementation of a nursing-driven protocol for suspected Urinary Tract Infection (sUTI) based on the American Medical Director’s Association Clinical Practice Guideline: Common Infections. An interdisciplinary team approach to evidence-based clinical change was utilized through use of the Iowa Model of Evidence-based Practice to Promote Quality Care. Both the process and the intervention were evaluated through analysis of outcome data including rates of urinary tract infection, compliance with the guideline recommendations, measurement of adverse outcomes, and evaluation of policy. The sUTI protocol was piloted for a three-month period and outcomes included a reduction in incidence of UTI from 5.4 to 3.8 infections per 1000 resident days and statistically significant improvements in center compliance with clinical practice guidelines for recognition and management of suspected UTI. The analysis of cost, benefits, and sustainability of this evidence-based guideline is discussed.

Included in

Nursing Commons