Reducing urinary tract infections through hydration

This initiative aims to reduce the number of urinary tract infections (UTIs) in care home residents which require antibiotics or admission to hospital. Developed in partnership with East Berkshire Clinical Commissioning Group, it is now delivering sustained improvements to keep residents in care homes happy and healthy. We are sharing all guidance, toolkits and resources relating to our ‘Good Hydration!’ work via this website .


Read more on this award-winning project in this poster, this case study or this blog.


Watch the six short Good Hydration! training videos above


Test your knowledge of the importance of good hydration in our quiz (certificate on successful completion)


The care homes hydration quality improvement project

Key outcomes:

  • UTI admission to hospital reduced by 66%

  • The incidence of UTIs requiring antibiotics has reduced from 1 every 13 days at baseline to 1 every 47 days since the project commenced.

  • One residential home has been UTI free for 230 days.

The five tests of change:

  • Introduction of a poster with importance of hydration and signs and symptoms of a UTI

  • Staff hydration training

  • Introduction of a structured drinks round, seven times a day

  • Residents’ hydration training

  • Food and fluids chart – designed by care home staff.

Baseline data was collected for two months before the project officially started using safety crosses. A red sticker indicated if a resident had a UTI requiring admission to hospital, an orange sticker indicated a resident requiring antibiotics for a UTI and a green sticker was an incident-free day.

The training was aimed at all staff including nurses, care workers, activities coordinators, managers and nutrition advisors. It covered the anatomy and physiology of the urinary system, the importance of hydration and how to recognise dehydration, the effect of certain medications on the kidneys, signs and symptoms of a UTI and how to implement a structured drinks round.

Each care home chose the times that would best suit their routine and the aim was to achieve seven structured drinks rounds per day.  This information was collected by the member of staff undertaking the drinks round by noting it in the allocated folder. At the end of each day the number of drinks rounds were tallied at the end of the page and the manager collated the information on a weekly basis.

The graphs below note the number of UTIs requiring antibiotics or admission to hospital. It is important to note that when examining the data one unwell resident can have multiple UTIs in the month due to other exacerbating conditions.


The following feedback was received from a focus group involving the care homes:

  • A positive experience being part of the project
  • Some residents ask for their drink if we are late
  • A resident who had a UTI every six weeks used the drinks diary (had capacity) and realised how little they were drinking. Increased fluids of own free will. Improvement noted in walking, social interaction and has been UTI-free for over eight months
  • Noticed improved skin integrity and fewer falls
  • Fewer GP visits
  • Greater understanding within staffing groups of importance of hydration
  • No major increase in cost or time commitment

Awards won


Three prizes at the PrescQIPP awards including the overall gold award.

Wider adoption

  • This project is now being adopted within Oxfordshire and East Berkshire.
  • Discussions are in process with Buckinghamshire and CCGs and local authorities in the Bedford, Luton and Milton Keynes Sustainability Transformation Partnership.

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