Urinary tract infections (UTIs) entail contagions that occur at various parts of the body such as the bladder, urethra, and the kidney. Over the years, they have become a common occurrence with about 75 percent of the incidents acquired reported in healthcare settings. The increase in the occurrence and prevalence of UTIs emanates from the use of a urinary catheter inserted into a patients bladder through the urethra with the purpose of draining urine. UTIs can lead to alterations in the mental state of a patient especially older people through confusion and challenging behaviors. These alterations have safety and communication implications particularly for the older people and for the provision of care, person-centered nursing treatment.
Safety and Communication Implications to Elderly People
The occurrence of urinary tract infections is common among older people and may result in severe complications such as changes in their mental status. The diagnosis of UTIs among the older generation brings about complications based on the high prevalence of asymptomatic bacteria which does not involve any mode of treatment. The complication involves the challenges experienced in interpreting the signs and symptoms of UTIs among the older people. The older generation possesses a significant morbidity level which tends to undermine the communication between the healthcare practitioners and the patients. According to research, about 20 percent of the patients admitted in hospitals receive urinary catheter treatment during their stay (Maher et al., 2012). This brings about risk factors such as the development of urinary tract infections based on the prolonged use of the catheter. Moreover, urinary tract infections entail one of the most common contagious problems affecting older people in the community as well as in healthcare settings. These infections may worsen and affect the achievement of effective treatment through underlying medical conditions which result in adverse effects on the patients recovery.
According to research, the pathophysiology nature of UTIs is quite complex but one of the most common cause entails the growth of bacteria around the periurethral area (Juthani-Mehta et al., 2009). The individuals diagnosed with urinary tract infections may face acute and chronic kidney conditions which may result in permanent damage to their vital organs or kidney failure. Most importantly, UTIs have been attributed to the occurrence of sepsis, a condition which affects the bloodstream and potentially threatens an individuals life. Elderly people have been proven more vulnerable to UTIs than the younger generation due to a variety of reasons. One of these reasons entails the general susceptibility to urinary tract infections which emanates from weaknesses in elderly peoples immune system (Matata et al., 2013). These people experience a weakening in the bladder muscles as well as the pelvic floor which in turn results in an increase in their retention of urine. When the urine retained in the bladder increases, it indicates signs of incomplete emptying of the bladder as well as incontinence. These factors largely contribute to the occurrence of urinary tract infections among elderly people.
Some of the signs and symptoms attributed to urinary tract infections include the presence of blood in the urine, foul smell, and a burning sensation while urinating (Matata et al., 2013). These may be followed closely by the frequent urge to urinate, a pressure at the lower pelvis region, low fever and chilly nights. Some of the effects associated with urinary tract infections among older people include adverse implications to the patients quality of life and the enhancement of social isolation. Additionally, older people with urinary tract infections tend to develop psychological conditions such as fear of losing urine while they are in public places (Matata et al., 2013). They are also embarrassed about their condition which in turn brings about constraints in their activities, the arousal of low-esteem feelings and interference in their personal relations. Research indicates that some of these effects are the main why most elderly people are institutionalized.
Besides, elderly people suffering from urinary tract infections may fail to exhibit the symptoms outlined above due to the inability of their immune systems to build up significant responses to the illness. Additionally, due to the lack of perceptible symptoms, most elderly people fail to express their discomfort to the practitioners providing necessary care (Agata, Loeb and Mitchell, 2013). This brings about severe implications to the patients safety in terms of health due to poor communication of how he/she feels. Research further stipulates that because the bodies of elderly people respond differently to urinary tract infections, it is imperative for caregivers to consider and determine distinct signs and symptoms. For instance, the National Institutes of Health (NIH) insists that some of the symptoms identified from urinary tract infections are mostly confused for early stages of Alzheimers disease or dementia. Some of the symptoms, mostly identified in elderly people include agitation, confusion, dizziness, and hallucinations. These are also coupled with unusual changes in their behavior and loss of coordination as well poor motor skills. These symptoms affect the elderly peoples ability to control their emotions in that they disorient their mental state and may lead to violence towards the nurses and medical practitioners (Agata, Loeb and Mitchell, 2013). Furthermore, adverse effects of the patients mental state may interfere with their communication thereby hindering the achievement of effective treatment. When communication is affected, the patient may fail to express instances of discomfort which in turn may result in a fatality.
Communication and Safety Implications related to UTIs in Elderly People among Nurses
The diagnosis of urinary tract infections accentuates the challenges medical practitioners face in their attempt to offer treatment to older people. On the one hand, it necessitates the presence of genitourinary symptoms based on a positive urine culture. Nonetheless, elderly people in nursing homes and care centers often suffer from significant cognitive deficits which impair their ability of communication as well as chronic genitourinary symptoms such as frequency, urgency and incontinence (Agata, Loeb and Mitchell, 2013). These factors bring about challenges in the diagnosis of symptomatic urinary tract infection among elderly people. For instance, when diagnosed with UTIs, elderly people tend to present non-specific indicators such as confusion, anorexia and a significant reduction in the functional status. The presence of these nonconforming symptoms brings about additional challenges among nurses in the differentiation of UTIs from other medical conditions (Matata et al., 2013). These challenges include the inability of elderly people to communicate or express their feelings with regards to discomfort or pressure thereby hindering effective treatment.
Research further avows that elderly people have a high prevalence of bacteriuria plus pyuria which facilitates the effective diagnosis of UTIs. Although it provides relevant aspects necessary for the diagnosis, bacteriuria plus pyuria confirms the presence of UTIs based on results from laboratory tests (Agata, Loeb and Mitchell, 2013). However, nurses are faced with the challenge of distinguishing between UTIs and other disorders particularly when unusual symptoms are observed. Furthermore, in instances where elderly patients fail to communicate due to confusion and behavioral challenges, nurses may conduct incorrect diagnosis and proceed to prescribe antibiotics based on unusual symptoms. The implication of such activities entails the development of potential risks to the safety of the patient. Therefore, the appropriate mitigation of the implications related to UTIs among nurses requires the incorporation of various methods of diagnosis to determine the specific course of action to be taken.
Conclusion
Urinary tract infections (UTIs) occur mostly among elderly people particularly those institutionalized in care homes and health facilities. Some of the symptoms associated with the infections entail dementia, unusual changes in behavior, hallucinations, agitation, poor coordination, just to mention but a few. These signs may bring about significant changes in the patients mental state thereby bringing about inconsistency in the behavior as well as confusion. Most importantly, the effects on the individuals mental capacity may result in safety and communication implications particularly among elderly people and the nurses responsible for providing care. When these individual fail to communicate, practitioners are unable to determine alarming signs thus leaving them vulnerable to potential risks. Therefore, it is imperative that practitioners look for other signs of diagnosing urinary tract infections among elderly people with the aim of improving their safety. If the infections are not treated, they may lead to chronic illnesses such as kidney failure.
References
Agata, E. D., Loeb, M. B., & Mitchell, S. L. (2013). Challenges in assessing nursing home residents with advanced dementia for suspected urinary tract infections. Journal of the American Geriatrics Society, 61(1), 62-66. doi:10.1111/jgs.12070
Faught, D. (2014). Delirium: The nurse's role in prevention, diagnosis and treatment. Discovery Service for Univ. of Newcastle. MEDSURG Nursing, 23(5), 301-305.
Juthani-Mehta, M., Quagliarello, V., Perrelli, E., Towle, V., Van Ness, P. H., & Tinetti, M. (2009). Clinical features to identify urinary tract infection in nursing home residents: A cohort study. Journal of the American Geriatrics Society, 57(6), 963-970. doi:10.1111/j.1532-5415.2009.02227.x
Maher, A. B., Meehan, A. J., Hertz, K., Hommel, A., MacDonald, V., OSullivan, M. P., Taylor, A. (2012). Acute nursing care of the older adult with fragility hip fracture: An international perspective (Part 1). International Journal of Orthopedic and Trauma Nursing, 16(4), 177-194. doi:10.1016/j.ijotn.2012.09.001
Matata, C., Defres, S., Jones, C., Gummery, A., & Solomon, T. (2013). Management of acute confusion in patients with CNS infections. Nursing Standard, 28(15), 49-58. doi:10.7748/ns2013.12.28.15.49.e7852
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