Don’t order a urine culture unless minimum criteria for a UTI are present.

In a non-catheterized resident, the minimum criteria include:
acute dysuria or 2 or more of the following:
fever [> 37.9°C (100°F) or a 1.5°C (2.4°F) increase above baseline on at least two occasions over the last 12 hours], new or worsening urgency, frequency, suprapubic pain, gross hematuria, flank pain, urinary incontinence
In a catheterized resident, minimum criteria include:
Any one of the following after alternate explanations have been excluded: fever [> 37.9°C (100°F) or a 1.5° C (2.4°F) increase above baseline on at least two occasions over the past 12 hours], flank pain, shaking chills, new onset delirium
[1] Please note that these are clinical criteria validated for the diagnosis for a UTI and differ from criteria that are used for surveillance
[2] Note that confusion alone is not a symptom of UTI in non-catheterized residents.

Using Antibiotics Wisely in Long-Term Care