First Advisor

Hummel, Faye I.

Date Created



The practice of mistaking asymptomatic bacteriuria (ASB) for urinary tract infections (UTI) is widespread in nursing homes and is contributing to patient overtreatment and adverse side effects such as clostridium difficile and multi-drug resistant microorganisms. The purpose of this DNP capstone project was to (a) write evidence-based policy and procedures (P&Ps) for evaluating institutionalized elders with clinical status changes when UTI was suspected, (b) utilize nursing leadership teams (NLT) in four northern Colorado nursing homes to implement evidence-based practice (EBP), and (c) evaluate implementation methods for their success in changing practice. Bandura’s self-efficacy theory, Plsek’s philosophy of adopting innovation in health care, and Grol and Wensing’s framework for successful EBP implementation provided the groundwork for working with the NLTs. New, unified, and evidence-based P&Ps for ASB and UTIs were created and fully replaced all nursing homes’ former policies. Successful implementation was achieved in three of the four nursing homes. The nursing leadership team was critical to both the success and failure of implementation. The DNP capstone project supported current literature on implementing EBP in health care settings, as well as provided new insight into cross-organizational barriers needing to be overcome and how to sustain EBP once it has been implemented.

Abstract Format



Nursing; Asymptomatic bacteriuria; Urinary tract infections; Nursing home elders; Evidence-based practice; Self-efficacy theory


163 pages

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