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SIGN decision support

This section reflects the issues likely to be of most concern to patients and their carers. These points are provided for use by healthcare professionals when discussing urinary tract infection with patients and carers and in guiding the development of locally-produced information materials.

Checklist for provision of information

This section gives examples of the information patients/carers may find helpful at the key stages of the patient journey. The checklist was designed by members of the guideline development group based on their experience and their understanding of the evidence base. The checklist is neither exhaustive nor exclusive.

Diagnosis

  Explain the symptoms of UTI, how to tell a UTI might be present and when to seek medical advice, eg from GP or pharmacist.

Inform women of the cause of UTIs and the effect UTIs have on the body.

Discuss with women how having other conditions can make them more susceptible to UTIs, eg diabetes. Offer time to answer questions women may have.

Discuss the implications of recurring UTIs on health in general, including the bladder.

Discuss with women aged under 65 years how to provide a urine sample for dipstick testing, including advice around ensuring the bladder has not been emptied for at least four hours before taking the sample.

Provide women with the SIGN patient version of this guideline to help them understand and manage UTIs.

Explain the rationale for not prescribing and delayed prescribing.

Treatment

Explain the difference between a 3-day and a 7-day course of antibiotics and the reasons for using one or the other.

Ensure women understand the need to finish the course of antibiotics.

Advise women how long it will be before they start to feel better after starting treatment.

Inform women of common side effects associated with treatment and advise them not to be concerned and not to stop treatment without discussion with a healthcare professional.

Discuss potential drug interactions with other prescribed medicines they may be taking.

Advise women to return to their GP or NHS24 (at weekends or evenings) if symptoms don’t improve with treatment, get worse or come back after treatment.

Explain the long-term effects that can occur when taking long-term prophylactic antibiotics.

Discuss steps women can take to reduce the chances of having further UTIs, including:

  • drinking plenty of fluid.
  • avoidance of spermicide containing contraceptives.
  • personal hygiene.
  • voiding behaviours.

Publications from SIGN

SIGN Decision Support: risk reduction and management of delirium

SIGN 157: Risk reduction and management of delirium

This guideline provides recommendations based on current evidence for best practice in the detection, assessment, treatment and follow up of adults with delirium, as well as reducing the risk of delirium. The guideline applies to all settings: home, long-term care, hospital, and hospice and includes recommendations on the regulation of bladder and bowel function.

SIGN patient versions of guidelines are documents that ‘translate’ guideline recommendations and their rationales, originally developed for healthcare professionals, into a form that is more easily understood and used by patients and the public. They are intended to:

  • help patients and carers understand what the latest evidence supports around diagnosis, treatment and self care
  • empower patients to participate fully in decisions around management of their condition in discussion with healthcare professionals
  • highlight for patients where there are areas of uncertainty.

Delirium patient information booklet

This booklet describes recommendations from SIGN 157: Risk reduction and management of delirium and explains for patients and carers:

  • what delirium is
  • how to reduce the risk of experiencing delirium
  • what it is like to have delirium
  • how it is identified
  • how it is treated, and
  • the care provided.

Sources of further information

Bladder Health
bladderhealthuk.org/cystitis-utis-fowlerssyndrome
Bladder Health UK gives support to people with all forms of cystitis, overactive bladder and continence issues together with their families and friends.

British Association of Urological Surgeons
www.baus.org.uk/patients/conditions/14/urinary_infection_a
The British Association of Urological Surgeons is a registered charity which promotes the highest standards of practice in urology, for the benefit of patients.

The Cystitis & Overactive Bladder Foundation
www.cobfoundation.org/bacterial-cystitis
The Cystitis and Overactive Bladder Foundation is the largest bladder patient support charity in the UK. It gives support to people with all forms of cystitis, overactive bladder and continence issues together with their families and friends.

Healthcare Improvement Scotland
ihub.scot/improvement-programmes/acute-care-portfolio/older-people-in-acute-care/delirium
In collaboration with the Scottish Delirium Association, NHS Education for Scotland and colleagues across NHSScotland, Healthcare Improvement Scotland has developed a range of tools and resources to support improvements in the identification and immediate management of delirium. A THINK Delirium toolkit has been produced to provide easy access to all of these tools and resources.

National Urinary Catheter Care Passport
www.hps.scot.nhs.uk/web-resources-container/urinary-catheter-care-passport
The National Urinary Catheter Care Passport was developed by Health Protection Scotland and the Scottish Urinary Tract Infection Network. It is a patient-held record which provides information to support individuals to effectively manage their catheters and allows for revisions to clinical management plans, the history of catheter changes and a record of catheter maintenance to be recorded.

NHS
www.nhs.uk/conditions/urinary-tract-infections-utis
The NHS website is the UK's biggest health website and contains thousands of freely available articles, videos, tools and apps to help people make the best choices about their health and wellbeing.

NHS Inform
www.nhsinform.scot/illnesses-and-conditions/kidneys-bladder-and-prostate/urinary-tract-infection-uti
NHS Inform is a patient access website providing health advice across a wide range of topics.

Patient
patient.info/womens-health/lower-urinary-tract-symptoms-in-women-luts/cystitis-in-women
Patient is a health information website which contains patient advice reviewed by doctors and other health professionals.