Failure to Notify Physician and Treat UTI in Catheterized Resident
Penalty
Summary
A deficiency occurred when a resident with an indwelling catheter and diagnoses including obstructive and reflux uropathy and type II diabetes mellitus did not receive appropriate treatment and services related to a urinary tract infection (UTI). The resident was admitted to hospice and had impaired cognition. A urine culture collected showed the presence of Acinetobacter baumannii at a significant level, with susceptibility only to amikacin. Despite these findings, there was no documentation in the medical record of UTI symptoms, no evidence that the physician was notified of the urine culture and sensitivity results, and no order for the indicated antibiotic was found. An interview with the Infection Preventionist confirmed that there were no documented signs or symptoms of a UTI and that, according to McGeer's criteria, such symptoms are required before proceeding with urinalysis. The Infection Preventionist also confirmed that no antibiotics were ordered and that there was no evidence of physician notification regarding the positive urine culture. Facility policy and CDC guidance require systems for infection prevention, identification, and reporting, but these were not followed in this case.