Delay in UTI Treatment Due to Lab and Communication Issues
Penalty
Summary
A deficiency was identified when a resident with a history of diabetes mellitus, chronic kidney disease, heart failure, and recurrent urinary tract infections (UTIs) experienced a delay in the treatment of a symptomatic UTI. The resident, who was cognitively intact and dependent for transfers with frequent incontinence, reported worsening burning and discomfort during urination. A nurse practitioner ordered a urine analysis, and a urine sample was collected via straight catheter. However, the initial sample was rejected by the hospital lab due to being in the wrong container, causing a delay as the sample had to be resent to another lab the following day. The urine culture results were received several days later and subsequently sent to the infectious disease office for review. Despite the resident's ongoing symptoms, including discomfort and pain with urination, no antibiotic treatment was initiated for over a week after the onset of symptoms. Interviews with the resident and her daughter confirmed the prolonged wait for treatment, and the Director of Nursing acknowledged the extended delay in both obtaining lab results and starting appropriate therapy.