Urinary Tract Infection Uncomplicated in Women Standing Order
EFFECTIVE DATE:____________________________________________________________
APPROVED FOR USE AS A POPULATION BASED STANDING ORDER BY: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________
PURPOSE: To provide a population-based standing order for women ages 18-65 with classic symptoms of a urinary tract infection without complications: Absence of fever, flank pain, or other suspicion for pyelonephritis and who are able to take oral medication.
POLICY: This standing order follows AAFP guidelines in addition to Schmitt-Thompson nurse triage protocols and is to be implemented by the registered nurse as part of telephone triage service.
PROCEDURE:
- The RN will follow Clear Triage software assessment pathway using Schmitt-Thompson approved protocols for nurse triage to include “Urinary Symptoms” and “Urination Pain - Female”
- The RN will screen the patient for complicated symptoms or history to include bedridden patients and those with an artificial heart valve or artificial joint, diabetes, and/or weak immune systems. If the patient answers “yes” to any complicating factors or history the RN must advise the patient according to the care advice found in the selected protocol. If the patient answers “no” to any complicating factors or history the RN may continue with procedure for standing order.
- Symptomatic women without complicating factors or history will be treated with Nitrofurantoin 100 mg by mouth twice daily for 5 days. Dispense #10. No refills. (upon confirmation by patient of no known nitrofurantoin allergy)
- RN will provide the patient with care advice as indicated by Schmitt-Thompson protocols in Clear Triage software to include reasons to call back i.e., fever, flank pain, new/worsening symptoms, no improvement on antibiotic within 3 days.