Table 4.
Evidence Categories with Importance Scores and Utilities for All Nurses (N = 881) and by Time Condition Group
| “I would call about a suspected UTI” Importance Scores (%) and Utilities (OR, [95% CI]) |
|||
|---|---|---|---|
| Categories and Information | Total (All Nurses) | Self-Paced Group (n=437; 49.6%) | Forced-deliberation group N=444; 50.4%) |
| Lower Urinary Tract Status | 22.8% | 24.1% | 21.0% |
| No lower urinary tract signs/symptoms | 0.00 | 0.00 | 0.00 |
| Painful or difficult urination | 4.85 (4.16, 5.65) * | 5.65 (4.53, 7.04) * | 4.21 (3.39, 5.21) * |
| Obvious blood in urine | 4.66 (3.99, 5.44) * | 4.90 (3.93, 6.11) * | 4.39 (3.53, 5.47) * |
| Change in urine clarity or odor | 2.76 (2.39, 3.18) * | 3.09 (2.52, 3.78) * | 2.45 (2.00, 2.99) * |
| New or worsening frequency | 2.27 (1.93, 2.67) * | 2.12 (1.69, 2.66) * | 2.41 (1.91, 3.04) * |
| Body Temperature | 22.2% | 19.7% | 23.7% |
| Temperature is 97.5°F | 0.00 | 0.00 | 0.00 |
| Temperature is 101.5°F | 3.80 (3.28, 4.42) * | 3.74 (3.05, 4.59) * | 3.95 (3.18, 4.90) * |
| Temperature is 99.5°F | 1.71 (1.51, 1.95) * | 1.90 (1.59, 2.28) * | 1.57 (1.31, 1.87) * |
| Temperature is 96.5°F | 0.82 (0.72, 0.92) * | 0.90 (0.76, 1.07) | 0.74 (0.63, 0.89) * |
| Urinalysis | 18.0% | 18.4% | 16.9% |
| Negative leukocyte esterase, negative nitrates | 0.00 | 0.00 | 0.00 |
| Positive leukocyte esterase, positive nitrates | 3.48 (3.04, 3.99) * | 3.75 (3.09, 4.55) * | 3.30 (2.73, 4.00) * |
| Positive leukocyte esterase, negative nitrates | 2.16 (1.90, 2.47) * | 2.20 (1.83, 2.65) * | 2.14 (1.78, 2.58) * |
| Unavailable/Not performed | 1.48 (1.30, 1.68) * | 1.45 (1.21, 1.74) * | 1.52 (1.26, 1.82) * |
| UTI Risk | 9.7% | 10.0% | 8.9% |
| No history of UTIs or current indwelling catheters | 0.00 | 0.00 | 0.00 |
| Current indwelling catheter + history of three UTIs | 1.96 (1.68, 2.28) * | 2.06 (1.66, 2.55) * | 1.87 (1.51, 2.33) * |
| History of three UTIs over past year | 1.46 (1.28, 1.67) * | 1.54 (1.28, 1.85) * | 1.39 (1.15, 1.68) * |
| Current indwelling catheter | 1.20 (1.03, 1.39) * | 1.18 (0.96, 1.45) | 1.22 (0.99, 1.51) |
| Physical Examination | 7.8% | 7.2% | 8.4% |
| Normal physical exam | 0.00 | 0.00 | 0.00 |
| Suprapubic/costovertebral angle tenderness | 1.71 (1.52, 1.93) * | 1.67 (1.42, 1.98) * | 1.76 (1.49, 2.09) * |
| Redness and warmth on left lower leg | 1.15 (1.01, 1.31) * | 1.31 (1.08, 1.58) * | 1.02 (0.84, 1.23) |
| Cough and work of breathing | 1.09 (0.96, 1.25) | 1.26 (1.04, 1.51) * | 0.98 (0.81, 1.18) |
| Mental Status | 6.3% | 5.7% | 6.9% |
| Usual state of health | 0.00 | 0.00 | 0.00 |
| New/Worsening confusion | 1.54 (1.35, 1.76) * | 1.50 (1.25, 1.81) * | 1.59 (1.32, 1.92) * |
| New/Worsening agitation | 1.52 (1.33, 1.73) * | 1.43 (1.19, 1.72) * | 1.62 (1.35, 1.95) * |
| Sleeping more than usual | 1.20 (1.05, 1.36) * | 1.25 (1.04, 1.51) * | 1.15 (0.96, 1.38) |
| Antimicrobial Request | 5.2% | 4.6% | 6.2% |
| No antimicrobial request | 0.00 | 0.00 | 0.00 |
| Antimicrobial request from family | 1.44 (1.25, 1.65) * | 1.33 (1.10, 1.62) * | 1.55 (1.28, 1.89) * |
| Antimicrobial request from resident | 1.31 (1.13, 1.50) * | 1.39 (1.14, 1.70) * | 1.23 (1.00, 1.50) * |
| Functional Status | 4.7% | 4.6% | 4.3% |
| Usual state of health | 0.00 | 0.00 | 0.00 |
| New/Increased falls | 1.38 (1.20, 1.60) * | 1.39 (1.13, 1.70) * | 1.35 (1.10, 1.67) * |
| New/Increased resistance to care | 1.26 (1.09, 1.45) * | 1.22 (1.00, 1.50) | 1.28 (1.04, 1.57) * |
| New/Worsening difficulties with ambulation/transfers | 1.18 (1.02, 1.36) * | 1.20 (0.98, 1.48) | 1.14 (0.93, 1.40) |
| Reduced intake of food and liquids | 1.15 (0.99, 1.33) | 1.08 (0.88, 1.32) | 1.23 (1.00, 1.51) |
| Goals of Care | 2.2% | 3.5% | 1.1% |
| Comfort care measures | 0.00 | 0.00 | 0.00 |
| Full scope of treatment | 1.16 (1.04, 1.30) * | 1.29 (1.10, 1.51) * | 1.07 (0.91, 1.26) |
| Limited additional interventions | 1.14 (1.02, 1.27) * | 1.21 (1.03, 1.42) * | 1.08 (0.92, 1.27) |
| Resident Type | 1.1% | 2.3% | 2.6% |
| 84 year-old cognitively-intact man | 0.00 | 0.00 | 0.00 |
| 84 year-old cognitively-intact woman | 1.07 (0.93, 1.22) | 1.18 (0.98, 1.43) | 0.96 (0.79, 1.16) |
| 84 year-old man with dementia | 1.03 (0.85, 1.25) | 1.08 (0.82, 1.42) | 0.97 (0.73, 1.27) |
| 84 year-old woman with dementia | 0.99 (0.82, 1.19) | 1.17 (0.90, 1.52) | 0.83 (0.64, 1.08) |
Note. Evidence-based information is bolded. OR = Odds ratio, CI = Confidence interval.
*
p < .05; two-sided.