Biomedical subjects

Ruth Paur

Publications and source records attributed to Ruth Paur.

5 recordsLinked to original sources

PubMed2004

Urinary tract infections. Does the smell really tell?

Asymptomatic bacteriuria is considered a transient and benign condition in the geriatric population. Before a diagnosis of a urinary tract infection (UTI) can be made, symptoms and significant bacteriuria must be present. One of these symptoms is malodorous urine. Other symptoms of a UTI, typical in the younger population, have been found to be absent or misleading in the older adult population. Though early detection of UTIs improves outcomes, unnecessary laboratory tests are costly and time-consuming, and may encourage inappropriate antibiotic therapy. The purpose of this study was to determine if urine odor is an accurate predictor of a UTI in the older adult incontinent nursing home population. Ninety-seven recently wet incontinence pads of residents in six Midwestern nursing homes were evaluated for odor within 1 hour of voiding. These results were compared to microscopy and culture results of clean-catch urine samples from these individuals. Defining a UTI as either bacteriuria or bacteriuria and pyuria, using urine odor to identify a UTI resulted in error in one third of cases. Results of this study indicate smell of urine in incontinence pads may be an absent or misleading symptom for UTIs in elderly nursing home residents.

Aged↗

PubMed2003

Pyuria detection using a dipstick applied to urine in incontinence pads.

The purpose of this study was to determine whether pressing a dipstick into a pad within 2 hours of urine saturation detected pyuria as effectively as immersing a dipstick in a urine specimen. Sensitivity, specificity, and positive and negative predictive values indicated that results of the pad method were as effective as those of direct dipstick into clean-catch urine in detecting pyuria. In the elderly, sensitivity of the pad method was 100%, indicating this would be an effective method for initial assessment of pyuria.

Adolescent↗

PubMedDate not supplied

Urinary tract infections in the elderly: a survey of physicians and nurses.

The purpose of this study was to identify, in the presence of significant bacteriuria, the symptoms that determine and conditions that affect whether a physician will begin antibiotic treatment in the elderly; 2 physician groups were studied: geriatric physicians and family practice/internal medicine physicians. We also sought to compare these results to symptoms and conditions that determine nurses' decisions to begin assessment for urinary tract infections (UTIs) in this population. We also sought to determine the importance these 3 groups placed of monitoring asymptomatic bacteriuria for specific elderly patient populations. Quantitative questionnaires were sent to a convenience sample of 1900 physicians and nurses. Sixty-eight of the 300 geriatric physicians (23%), 113 of the 1000 family practice or internal medicine physicians (11%), and 192 of the 600 nurses (32%) returned surveys. Results showed differences between physician groups and nurses concerning whether cloudy and malodorous urine were symptoms of a UTI. This survey also found that physicians consider patient conditions to a greater extent than nurses do in their decisions regarding UTIs. Geriatric physicians appear to be less likely to monitor asymptomatic bacteriuria in any elderly patient population. Finally, we found that with regard to monitoring asymptomatic bacteriuria, both physician groups and the nurse group gave the greatest support for monitoring among elderly who have difficulty presenting symptoms of a UTI.

Aged↗

PubMedDate not supplied

A protocol for the urine dipstick/pad method.

The urinary tract accounts for nearly one third of all infections in the long-term care setting. This article reviews factors that influence nitrite and leukocyte esterase results obtained from traditional urine dipstick analysis for assessment of urinary tract infections in elderly long-term care residents. This article also proposes a protocol for a urine dipstick pressed into an incontinence pad as an alternative to dipstick analysis of a clean-catch or catheterized urine specimen.

Aged↗

PubMedDate not supplied

A survey regarding the use of the dipstick/pad method with elderly, incontinent patients.

OBJECTIVE: To determine if nurses and physicians would use the dipstick/pad method to test urine in elderly, incontinent patients with suspected urinary tract infection. DESIGN: A cross-sectional survey was sent to 1900 physicians and nurses. SETTING AND SUBJECTS: A convenience sample of nurses and geriatricians, family practice, and internal medicine physicians was obtained from lists on the Internet, a geriatric care conference, and a geriatric nursing journal mailing list. INSTRUMENTS: A 3-part questionnaire queried: (1) whether respondents would use the dipstick/pad method; (2) would they use results to initiate or monitor nonantibiotic interventions, antibiotic interventions, or determine further laboratory analysis; (3) would a particular combination of nitrite and leukocyte esterase results determine the need for further laboratory testing. Nurses were also asked if they had used results of dipstick urinalysis in their management of urinary tract infections. METHODS: The questionnaire was mailed to 300 geriatric physicians, 1000 internal medicine and family practice physicians, and 600 nurses. RESULTS: A total of 373 individuals (20%) responded to the survey. Sixty-five percent of the nurses responding had not used dipstick results; 90% of these nurses would consider using dipstick/pad results. Ninety-five percent of both the physician groups and the nurses who had previously used dipstick results indicated that they would consider using the dipstick/pad method. Determining the need for further laboratory analyses was the most accepted application by all groups. No combination of nitrite and leukocyte esterase dipstick results elicited greater than a 76% agreement by either physician group with regard to outcomes for further analyses. CONCLUSIONS: Although the response rate was low, the results of this survey suggest that healthcare workers would consider using the dipstick/pad method with incontinent elderly patients in the assessment of a urinary tract infection, primarily to determine further laboratory tests.

Aged↗