Capella 4025 Assessment 4

Capella 4025 Assessment 4

Name

Capella university

NURS-FPX4025 Research and Evidence-Based Decision Making

Prof. Name

Date

Presenting the PICO(T) Process to Professional Peers

Urinary tract infections (UTIs) are a common and distressing condition that significantly impacts women’s health and quality of life. Characterized by symptoms such as frequent urination, pain during urination, and lower abdominal discomfort, UTIs are responsible for numerous healthcare visits. Approximately 41% of women in the U.S. are affected by UTIs during their lifetime, with nearly 10% experiencing at least one episode annually (Bono et al., 2025). Reducing recurrence and healthcare strain is crucial, making evidence-based strategies like prophylactic antibiotic use essential in managing recurrent UTIs in reproductive-aged women.

Diagnosis: Prognosis, Potential Risks, and Related Complications

UTIs present a recurring challenge, especially among adult women, often progressing to severe complications if left unmanaged. Persistent symptoms such as dysuria, urgency, and systemic manifestations like fever or flank pain signal severe infections, which may lead to renal complications and sepsis (Bono et al., 2025). Nearly half of the affected women encounter another infection within one year. This condition frequently results in hospital readmissions due to infection-related complications such as fluid retention and delayed recovery. The 16–35 age group is most affected, making early interventions vital.

The healthcare system bears a substantial financial burden due to UTIs, with over 10 million visits annually, including 2 million emergency room consultations, incurring costs up to $1.6 billion each year (Wang & LaSala, 2021). Several comorbidities further exacerbate UTI recurrence. Elderly women with diabetes, chronic kidney disease (CKD), or neurological conditions face heightened susceptibility. A study by Chao et al. (2021) using the FRAIL scale revealed that frailty correlates strongly with increased UTI incidence—each additional frailty factor raised UTI risk by 11%.

Contributing risk factors also include hormonal changes post-menopause, incomplete bladder emptying, and incontinence. The prevalence of UTIs increases with age, affecting 4.5% of individuals aged 16–50, 15% of those aged 51–70, and 22% of those over 70. Women with type 2 diabetes (T2D) have a significantly higher risk due to weakened immune defenses and urinary stasis. T2D prevalence is projected at 6,058 per 10,000 individuals, underlining its significance as a risk factor (Bodke et al., 2023). In such cases, timely diagnosis and preventative strategies like antibiotic prophylaxis can mitigate complications such as pyelonephritis or antibiotic resistance. Educational interventions and early treatment are paramount to reducing readmissions and improving long-term outcomes (Alghoraibi et al., 2023).

Formulating the Research Question

To address this ongoing issue in women’s health, the following PICO(T) question was developed: In adult females with recurrent UTIs (P), does daily prophylactic antibiotic use (I), compared to standard care or no prophylaxis (C), reduce recurrence rates and improve patient outcomes (O) over a 12-month period (T)? This query aims to inform and enhance clinical decision-making by evaluating the preventive effectiveness of antibiotic regimens.

PICO(T) Framework Table

Component	Description
Population	Adult females with recurrent urinary tract infections
Intervention	Daily administration of prophylactic antibiotics
Comparison	No prophylaxis or conventional treatment without preventive measures
Outcome	Reduction in recurrence rates and improved health outcomes
Time	12 months duration for outcome evaluation

This framework structures the research around a population vulnerable to repeated infections. The intervention involves administering low-dose antibiotics regularly to curb UTI recurrence (Luchristt et al., 2024). Comparatively, standard care lacks proactive measures, addressing infections only after onset. Expected outcomes include fewer hospital visits, better quality of life, and symptom control over a 12-month timeframe. This evidence-driven model aims to optimize preventive treatment pathways.

Summary of Evidence from Peer-Reviewed Literature

A comprehensive literature review was performed using databases such as PubMed, CINAHL, Cochrane Library, and Google Scholar. Articles were screened based on CRAAP criteria—currency, relevance, authority, accuracy, and purpose—to ensure data validity (Kalidas, 2021). Four peer-reviewed sources were selected to examine the impact of prophylactic antibiotics in reducing UTI recurrence.

Luchristt et al. (2024) found that a one-month prophylactic antibiotic plan was more effective than three-month regimens with lower doses over a 12-month follow-up. Their study, published in Urology, supports short-term intensive regimens for long-term effectiveness. Alghoraibi et al. (2023) investigated 477 adults, finding that continuous antibiotic use (Nitrofurantoin, Bactrim, or amoxicillin-clavulanic acid) significantly reduced recurrent UTIs and hospital visits (P < 0.001). This study emphasized specific medication preferences based on patient demographics and health conditions.

The American Urological Association (2025) supports antibiotic prophylaxis for women experiencing frequent UTIs, adding credibility and clinical relevance to its endorsement. Liu et al. (2020), in a review published in the American Journal of Infection Control, examined eight randomized trials and found that post-catheterization prophylaxis significantly lowered infection risks (RR = 0.47). Particularly beneficial among older adults and patients with prolonged catheter use, their findings balance efficacy with concerns regarding antibiotic resistance.

Summary of Key Evidence Sources Table

Source	Key Findings	Significance
Luchristt et al. (2024)	One-month prophylaxis reduced UTI recurrence more effectively than lower-dose, longer regimens	Short-term, intensive treatment yields longer-term results
Alghoraibi et al. (2023)	Daily antibiotic use reduced recurrence, ER visits, and admissions in patients with recurrent UTIs	Supports antibiotics for high-risk groups, tailored by condition
American Urological Association (2025)	Recommends antibiotic prophylaxis in women with frequent infections	Clinical guideline that validates preventive strategy
Liu et al. (2020)	Post-catheter prophylaxis effective in high-risk subgroups	Informs practice for catheterized or elderly patients

Evidence-Based Response to the PICO(T) Inquiry

The aggregated data consistently affirm that prophylactic antibiotic therapy significantly lowers the recurrence of UTIs in adult women. These interventions reduce hospital visits, alleviate symptoms, and enhance quality of life (Luchristt et al., 2024). Liu et al. (2020) provided additional evidence favoring prophylactic measures for high-risk populations. Successful implementation relies on patient adherence and provider oversight. However, socioeconomic disparities, access to care, and mental health status influence the outcomes. These variables highlight the need for personalized care approaches in future research.

Evidence-Guided Essential Care Actions

Implementing evidence-informed practices is crucial for improving health outcomes in women facing recurrent UTIs. Initial clinical evaluation should identify patients suitable for long-term prophylaxis based on infection frequency and severity. This ensures treatments are patient-specific and effective. The next step involves adopting evidence-backed interventions such as low-dose, daily antibiotic regimens proven to reduce recurrence and enhance recovery (Alghoraibi et al., 2023). Finally, ongoing patient education about symptom monitoring, hydration, and adherence is vital. When patients understand their role, outcomes improve due to greater treatment compliance (American Urological Association, 2025). This three-step approach strengthens infection management and reduces the need for emergency interventions.

Conclusion

This analysis underlines the value of utilizing evidence-based practices, particularly prophylactic antibiotics, to manage recurrent UTIs in adult women. Consistent use of preventive therapy significantly reduces recurrence, improves clinical outcomes, and lowers healthcare costs. When integrated into clinical practice, these strategies enhance quality of life and reduce the strain on emergency care systems.

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References

Alghoraibi, A., Asidan, A., Aljawaied, S., Almukhayzim, N., Alsaydan, B., Alamer, A., Baharoon, S., Masuadi, E., Shukairi, F., Layqah, L., & Baharoon, D. (2023). Recurrent urinary tract infection in adult patients, risk factors, and efficacy of low dose prophylactic antibiotics therapy. Journal of Epidemiology and Global Health, 13(2), 200–211. https://doi.org/10.1007/s44197-023-00105-4

American Urological Association. (2025). Recurrent uncomplicated urinary tract infections in women: AUA guidelines. https://www.auanet.org

Capella 4025 Assessment 4

Bodke, N., Wang, L., Salazar, T., & Gordon, A. (2023). Risk factors of recurrent urinary tract infections among women with diabetes. International Journal of Diabetes in Developing Countries, 43(1), 40–46. https://doi.org/10.1007/s13410-023-01028-w

Bono, M. J., Curtis, J. A., & Sparks, S. D. (2025). Burden and recurrence of urinary tract infections among women: Epidemiological perspectives. Urology Clinics of North America, 52(1), 55–70.

Chao, C. T., Wang, J., & Huang, J. W. (2021). Frailty and the risk of urinary tract infection in older adults with comorbidities. BMC Geriatrics, 21(1), 112. https://doi.org/10.1186/s12877-021-02084-y

Kalidas, D. (2021). Evaluating medical literature: Using the CRAAP test for clinical relevance. Journal of Medical Education, 16(3), 15–22.

Liu, H., Zhang, Y., & Li, X. (2020). Efficacy of prophylactic antibiotics after short-term urinary catheter use: A systematic review. American Journal of Infection Control, 48(7), 733–739. https://doi.org/10.1016/j.ajic.2020.01.013

Capella 4025 Assessment 4

Wang, L., & LaSala, C. A. (2021). Cost burden and emergency visits for urinary tract infections: A healthcare analysis. Health Policy and Technology, 10(2), 100–108. https://doi.org/10.1016/j.hlpt.2021.01.007

 

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