About the Program
Public Health Ontario (PHO) has developed the Urinary Tract Infection (UTI) Program to respond to concerns about the overuse of antibiotics for presumed UTIs in residents in long-term care homes (LTCHs) and the associated antibiotic-related harms. The UTI Program supports LTCHs to improve the management of UTIs for non-catheterized residents in their homes and helps them implement the organizational and individual practice changes required.
Note: This program is currently being evaluated; resources may be revised in the future based on evaluation findings. We welcome all feedback to firstname.lastname@example.org on the resources and the implementation strategies we have developed.
Why was the UTI Program developed?
- It is common to find bacteria in the urine of the elderly – but it does not always mean that they have a UTI.
- Older people are often given antibiotics for what health care providers and other caregivers assume to be UTIs.
- It can be harmful to treat somebody with antibiotics when they don’t need them.
- Antibiotic use can increase the risk of antibiotic resistance, which can make it more difficult to treat future infections.
NOTE: For more information on the overuse of antibiotics in long-term care homes, see infographic.
What are the five key practice changes involved in the UTI Program?
- Obtain urine cultures only when residents have the indicated clinical signs and symptoms of a UTI.
- Obtain and store urine cultures properly.
- Prescribe antibiotics only when specified criteria have been met, and reassess once urine culture and susceptibility results have been received.
- Do not use dipsticks to diagnose a UTI.
- Discontinue routine annual urine screening and screening at admission if residents do not have indicated clinical signs and symptoms of a UTI.
Implementing the UTI Program
The three phases of the UTI Program (assess, plan, implement) are designed to help LTCHs adopt and sustain best practices for managing and treating UTIs. Each phase is supported by tools and resources that have been developed based on current evidence in infection prevention and control, antimicrobial stewardship and clinical practice. The resources are listed in the pages that follow.
The Implementation Guide includes additional background information and details about the UTI Program’s activities and implementation strategies. We recommend downloading and/or printing the Implementation Guide for reference as you work through each of the implementation phases.
Understanding and Managing UTIs
PHO developed several resources to be used in the course of implementing the UTI Program. However, some LTCHs may wish to use the resources below without adopting the full program.
Assessing UTIs in your Residents and Organization:
Obtaining Urine Cultures: