Ms Monina Hernandez1,2, Professor Anastasia F. Hutchinson1,2, Monica Schoch1, Associate Professor Stéphane Bouchoucha1,2
1Deakin University, Australia, 2Australasian College for Infection Prevention and Control, Australia
Biography:
Monina Hernandez is an IPC consultant with 30+ years’ nursing experience in academic, governance, and clinical roles across aged care, primary, secondary and tertiary hospital settings in the Philippines, New Zealand, and Australia. She is Regional IPC Manager at TLC Healthcare and is pursuing PhD in Nursing at Deakin University.
Abstract:
Introduction
Urinary tract infections (UTIs) comprise 13%–50% of Australian residential aged care home (RACH) infections. In 2020, UTIs were the second most common infection (29.8%) and hospital transfer cause (28.6%) among older people in RACH.
Diagnostic inaccuracies stem from urine dipstick overreliance, underutilised microbiology, and resource constraints. Consequently, a tailored multimodal intervention embedding the Aged Care Quality and Safety Commission-endorsed "To Dip or Not to Dip" (TDNTD) evidence-based pathway was implemented. This study evaluates the multimodal intervention’s impact on UTI incidence and healthcare workers' knowledge and practices.
Methods
A pre-post, mixed-methods study was conducted in a 130-bed RACH. Phase 1 was a systematic database search (2013–2026) to design a tailored UTI multimodal intervention centred on the TDNTD strategy. Phase 2 comprised a two-month environmental scan guided by the Implementation in Context and Behaviour Change Wheel frameworks. Phase 3 involved health worker training and multimodal intervention implementation. Phase 4 was an evaluation of outcomes using pre- and post-tests, focus groups, and UTI surveillance data analysis.
Results
Fifty-one health workers (n=51) completed the phase 3 training. Phase 4 showed that health worker knowledge scores significantly increased from pre-test (x̄ =9.14, SD = 2.44) to post-test (x̄ =14.22, SD=2.81), t = 3.61, p < 0.001 (two-tailed) with mean increase of 5.08, 99% CI. Focus group interviews revealed improved documentation and practices, and increased health worker confidence. UTI cases decreased by 30-50%.
Conclusion
A RACH-tailored UTI multimodal intervention focused on the TDNTD clinical pathway reduced UTI rates while significantly improving staff knowledge and clinical practice.