| Summary: | Background: Referral of residents with urinary tract infections (UTIs) in residential aged care facilities (RACFs) to
hospital are common. However, there is limited information on what influences Registered Nurses’ (RN) decision-making
process. Aim: To investigate resident factors that influence RN’s decisions to escalate care. Design: A retrospective
cohort approach audited electronic clinical records of residents with UTIs. Methods: Data were extracted from the
electronic database and analyzed using descriptive and regression analysis. Approval was obtained from both the RACFs
and University Human Research Ethics Committee. Results: There was a higher likelihood of being referred to hospital
if residents were female, had had a past fall, had related comorbidity, or had abnormal vital signs. However, being older
and having a urinary catheter were protective factors for referral by the RN. Conclusion: Referral of residents with UTIs
by RNs to hospital is common in RACFs. Resident characteristics such as abnormal vital signs, past falls, and presence
of comorbidity influence referrals by RNs. Nurse Practitioners dedicated to the RACFs could complement the role of a
general practitioner. UTI-specific escalation protocols can assist RNs to make decisions about referrals. RNs’ related risk
factors also need to be examined to understand other influencing factors.
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