Failure to Follow Protocols for Antibiotic Use in UTI Treatment
Penalty
Summary
The facility failed to follow its established protocols for antibiotic use in the treatment of a urinary tract infection (UTI) for one resident. The resident, who had multiple diagnoses including malignant neoplasm of the endometrium, diabetes, chronic obstructive pulmonary disease, and neurogenic bladder, was admitted with an indwelling catheter. Progress notes indicated that a urine specimen was ordered and collected after the resident was observed to have cloudy urine with an abnormal smell. The urine culture revealed the presence of two organisms, Klebsiella pneumoniae and Proteus mirabilis, each at 70-99,000 CFU/ml. Despite the facility's UTI surveillance criteria requiring a culture result of greater than 100,000 CFU/ml for diagnosis, the resident was prescribed ciprofloxacin for a UTI. The Director of Nursing confirmed that the resident was treated for a UTI even though the culture results did not meet the facility's criteria for such a diagnosis. This action was based on the culture findings and symptoms, but did not align with the facility's established protocol for antibiotic use.