Uti Case Study Nursing

After reading through all models, I think there are lot of models that can used to solve the problem of increased incidence of urinary tract infections (UTIs) among older women who are 65 years or older. I am leaning toward an organizational model that is Rosswurm and Larrabee model, which is often used in the primary care setting (Ciliska, DiCenso, Melnyk, & Stetler, 2005). The six steps involved in this model are assess, link, synthesize, design, implement and evaluate, and integrate and maintain. In this case, we have identified problem i.e. increased incidence of UTIs. According to the model, we will need to assess the need to change the current practice of the clinic. The data should be collected on the clinic’s current practice, which
For instance, in this case we could say appropriate use of protocol for diagnosis and antibiotic use for older women 65 years or older could help reduce the rate of recurrent UTIs. The third step will involve searching literature relevant to our topic and collecting evidences from research which is best, cost-effective, and feasible. The research could be conducted on diagnosis for UTI among older women living in community, choice of antibiotic and duration of therapy to treat UTI among elderly women, prevention of recurrent UTIs among elderly women, and so forth. If the recommended guideline is different than the current practice guideline, then we will move into next step that is designing change. For instance: Mody and Juthani-Mehta (2014) recommended fosfomycin for older adults with highly resistant bacterial isolates. In addition, the optimal duration of therapy is unknown as there was no statistically significant different between short-course (3–6 days) and long-course (7–14 days) oral antibiotic therapy. I included evidence from one study, but we would perform more thorough and complete search to find best evidence. If the recommended guideline is different than our current practice, then we would implement this change and practice a new protocol to treat UTIs among older women aged 65 years or older and prevent recurrent UTIs. In this implementation step, we would also evaluate the sustainability and measure outcomes to determine the effectiveness of the EBP. Finally, we will share the guideline with other affiliated institution. However, we will continuously monitor and evaluate for the outcome to make sure that the rate of recurrence is declining after the implementation of new guidelines.

Question: What are your thought on using Rosswurm and Larrabee as an EBP model? What are additional steps can be taken to solve the problem on the basis of this model? Is there