In long-term care, small changes in everyday practice can have a big impact. Deb Schick, a nurse in Saskatchewan, played a key role in removing urine dipsticks, leading to lasting improvements in the care of older adults.

For 33 years, Deb Schick has worked at Sherbrooke Community Centre in Saskatoon, holding several leadership roles. As Leader of Professional Practice, her focus has been on driving thoughtful, evidence-informed improvements in care.

One of those changes began in 2013 when the Saskatchewan Ministry of Health released best practice guidelines showing that urine dipsticks are unreliable for diagnosing urinary tract infections (UTIs) in people over the age of 65. In many cases, these tests detect bacteria that may not be causing symptoms, leading to unnecessary antibiotic prescriptions. Using antibiotics when they are not needed not only has unwanted side effects for residents, but also contributes to larger public health concerns with the global rise of antimicrobial resistance.

In response, Schick led an educational effort at Sherbrooke to reduce the use of dipsticks. It started with staff education and, eventually, the decision to stop purchasing dipsticks altogether.

While the removal of dipsticks might sound simple, Schick is clear that replacing long-standing habits requires time, communication, and collaboration. When implementing this change at Sherbrooke, it was important to communicate with residents and their loved ones about how their potential UTI symptoms would be addressed.

Now, nurses monitor residents closely and investigate a range of possible causes before concluding someone may have a UTI. One key approach they take to address potential symptoms, like changes in behaviour, is to prioritize hydration. When a resident shows these signs, the nurse increases their fluid intake for at least 24 hours. Often, symptoms improve with continued monitoring. If not, the resident may be evaluated by a physician to determine if additional tests or assessments are needed.

For Schick, this approach is about more than just avoiding unnecessary tests, it’s about improving residents’ overall well-being. By reducing reliance on ineffective practices, she and her team can focus on providing care that improves their quality of life and promotes better health outcomes. It also ensures the true cause for a resident’s change in symptoms is properly addressed. Schick explains this is why the Ditch the Dipstick resources, released in 2024, are so important. It can help care homes look for changes in behaviour and decide the most appropriate treatment plan.

This shift encourages clinical staff to pause and ask questions instead of relying on automatic testing. She shares this encourages staff to think about an individual approach to care.

“What are we treating? Why are we treating?” she says, explaining her philosophy.

Schicks leadership and proactive approach has helped Sherbrooke Community Centre become a champion of antimicrobial stewardship and appropriate testing. She hopes the momentum doesn’t stop here, believing there are more opportunities across long-term care to re-evaluate long-standing practices and ensure care decisions are guided by evidence and centred on the needs of residents.

For Schick, the motivation for this work is clear.

“This work brings me right back to why I’m here and why,” she says. “It’s about the people we care for and care with.”