Capella FPX 4025 Assessment 3

Name

Capella university

NURS-FPX4025 Research and Evidence-Based Decision Making

Prof. Name

Date

Applying the PICO(T) Process

Recurrent urinary tract infections (rUTIs) are a common and distressing health issue, particularly among women (Foy et al., 2023). This paper addresses a clinical problem related to rUTIs by formulating a focused PICO(T) question and reviewing current evidence. Emphasis is placed on outcomes, risks, and healthcare disparities to inform best practices and support evidence-based, patient-centered interventions for prevention and care.

Diagnostic Summary and Health Disparities

Many women suffer greatly from UTIs, and these illnesses can affect the health and well-being of individuals, as well as society as a whole. Most outcomes occur due to re-infection from pathogenic bacteria such as E. coli, which can settle and continually irritate the urinary organs. Some causes of rUTIs include sexual activity, shifts in hormone levels, obstruction or stagnation in the urinary tract, poor personal hygiene, and certain methods of birth control. Women may experience worsening health problems, as well as develop antibiotic resistance and complications with their kidneys if they continue to have recurrent urinary tract infections.

People living in disadvantaged communities experience higher rates of recurrent UTIs owing to their limited access to medical care, financial resources and social support networks. Women living in underserved communities or representing marginalized groups are often challenged to receive the help they need for managing their rUTIs in a timely manner. Lack of access to care, inadequate insurance, low health knowledge and inaccurate discussions with doctors all contribute to a later diagnosis and greater chances of recurrence of the illness (Chan et al., 2024).

Inappropriate use of antibiotics and failure to practice preventive strategies worsen the symptoms and increase the likelihood of complications experienced by members of this high-risk group. Enumerating strategies to address these issues necessitates concerted educational efforts, expansion of healthcare resources, and efforts to adapt care to diverse cultural contexts. Applying these measures can greatly enhance the treatment and prognosis for chronic diseases while also reducing the likelihood of future flare-ups.

Formulating the PICO(T) Question

To address the recurring nature of UTIs in women, a PICO(T) question was developed:
“In adult women with a history of recurrent UTIs, does participation in nurse-led educational and behavioral interventions, compared to standard care alone, reduce the frequency of UTIs and antibiotic use over six months?”
This question aligns with the PICO(T) framework:

Population (P): Adult women with recurrent UTIs
Intervention (I): Nurse-led educational and behavioral strategies
Comparison (C): Usual care without added intervention
Outcome (O): Reduced UTI recurrence and decreased antibiotic reliance
Timeframe (T): Six months

This clinical question addresses a persistent healthcare concern and forms a structured basis for evidence-based practice aimed at enhancing patient outcomes and reducing long-term complications.

Evidence Retrieval Approach

An extensive literature review was performed to locate studies that evaluated nurse-led education and behavioral programs to prevent repeat UTIs among women. Three databases were chosen for the search because they feature reviewed scientific articles from the medical and nursing fields. Key search terms included: Recurrent UTIs, prevention, nurse-led interventions, educational programs, behavioral strategies, the use of antibiotics, and standard care. Operators like “AND” and “OR” were utilized to narrow down the research results.

Each study was assessed using the CRAAP analysis criteria. Additional analysis was conducted to evaluate each study for its design, author credentials, and the reputation of its source journal. This search method prioritized those studies that were most significant, reliable, and relevant to healthcare professionals when making decisions for the best patient care.

Evidence Synthesis and Clinical Implications

UTIs are among the most frequent bacterial illnesses worldwide and play an important role in global healthcare. Research has recently shown that access to UTI diagnosis, treatment, and patient outcomes can vary among different communities. Research conducted from 2019 to 2021 at Cooper University Hospital and reported in Moazamian et al. (2025) assessed UTI outcomes for patients. Patients living in areas of greater socioeconomic adversity had poorer outcomes, reflected by higher rates of both 30-day and 90-day readmissions.

Socioeconomic status has a widespread influence on patients managing and recovering from UTIs. A paper published in the International Journal for Equity in Health examined antibiotic resistance among UTIs treated in outpatient settings in 2024. The study revealed that more individuals with lower socioeconomic status were affected by antibiotic-resistant bacteria, which can worsen management and lead to frequent UTI relapses (Chan et al., 2024).

Foy et al. (2023) published in the Journal of Urology, Respiratory Diseases in 2023, examined how often patients with UTIs received virtual care during the COVID-19 outbreak. Study results showed that older adults and people from lower economic groups were less likely to access virtual care for their UTIs, putting them at risk of delayed treatment that could worsen their health. These studies emphasize the urgent need for intentional strategies to reduce these inequalities in addressing UTI treatment. A range of approaches can be employed to address these disparities. These include increasing access to care, implementing initiatives to minimize antibiotic resistance, and enhancing telehealth options to promote equal access to treatment.

Analysis of Evidence

The studies demonstrate that differences in UTI outcomes exist due to factors such as socioeconomic status, access to healthcare, and antibiotic resistance. The studies suggest that factors such as economic status heavily influence the success of UTI treatment and increase the likelihood of additional hospitalizations, repeated infections, and subsequent delays in medical attention for underprivileged individuals. Moazamian et al. (2025)’s findings indicate that poverty and other economic factors are closely linked to patients’ increased odds of UTI-related readmissions within 30 and 90 days after discharge. Chan et al. (2024) showed that patients from low-income households were more vulnerable to antibiotic-resistant bacteria, which jeopardized the success of UTI treatment and raised the risk of subsequent infections.

Foy et al. (2023) show how underrepresented words and topics in Women’s Wellness content topics reflect broader subject matter gaps. Finally, these results support efforts to enhance equitable healthcare practice by improving remote care availability, ensuring responsible antibiotic use, and safeguarding high-risk communities. Part of the rationale for these findings is that challenges with accessing care, technical infrastructure, and appropriate antibiotic use play significant roles in explaining these differences. It is further postulated that the study populations represent common patient populations and that healthcare providers should prioritize removing these disparities to achieve the best outcomes for those diagnosed with UTIs.

Conclusion

Factors such as social inequality, poor access to healthcare, and antibiotic resistance play a role in the recurrence of UTIs in women. Clinical studies have demonstrated the value of patient education and health behavior coaching by nurses to minimize the incidence of repeat UTIs and unnecessary antibiotic therapy. Addressing disparities through informed instruction, enhanced telehealth services, and advisable antibiotic use is important. Adopting personalized, research-informed interventions can improve outcomes and significantly lower hospital admissions among women who experience repeated UTIs in a variety of settings and backgrounds.

References

Chan, C. W., Westgard, L. K., Romasco, A., Gado, K., Doron, S., & Nadimpalli, M. L. (2024). Sociodemographic disparities in antibiotic-resistant outpatient urine cultures in a Boston hospital, 2015–2020: A cross-sectional analysis. International Journal for Equity in Health, 23(1). https://doi.org/10.1186/s12939-024-02308-y

Foy, M. E. D.-W., Albersheim, J. A., Grove, S. T., Hamid, L., Berryman, S., & Elliott, S. P. (2023). Disparities in access to virtual care for urinary tract infections during the COVID-19 era. Société Internationale d’Urologie Journal, 4(1), 20–26. https://doi.org/10.48083/urdy6133