differences in other medication types. The data shows that CVT can be a valuable resource for VA physicians to help manage the care of dementia patients. Disclosures: All authors have stated there are no financial disclosures to be made that are pertinent to this abstract. Current Prescribing Patterns for Urinary Tract Infections at a Skilled Nursing/Long Term Care Facility (SN/LTCF) Presenting Author: Christine Kloby, MSN, CRNP, Johns Hopkins University Author(s): C. Kloby, M. Katz; and R. McKenzie Introduction/Objective: In September 2014, the White House developed a “National Strategy for Combating Antibiotic-Resistant Bacteria” that included enhancing antimicrobial stewardship in SN/LTCFs. Urinary tract infections (UTIs) are one of the most frequently diagnosed infections in SN/ LTCFs, with the treatment of asymptomatic bacteriuria (ASB) a leading cause of antibiotic misuse. Despite the FDA’s recommendation not to use flouroquinolones (FQs) for uncomplicated UTIs, this class is still commonly prescribed in SNF/LTC. To aid in antimicrobial stewardship within a local SN/LTCF, we performed an epidemiological analysis of antimicrobial use in patients treated for suspected UTIs. Design/Methodology: During weekly visits from February through October 2017, data were collected for all residents treated with antibiotics for suspected UTI and entered into the REDCap data collection tool. Data included demographic characteristics of the residents, symptoms prior to treatment, microbiology results, and other laboratory data. Results: During the 9 month study period, 66 residents received antibi- otics for a suspected UTI. 42 (64%) were women. 25 residents (40%) were prescribed antibiotics while hospitalized and transferred to the facility on antibiotics. 56% did not meet criteria for treatmentd 27/46 (59%) without an indwelling catheter and 10/20 (50%) with an indwelling catheter. 46 residents (70%) had a positive (greater than 10 white blood cells per high powered field) urine analysis (UA); whereas 17 (26%) had a negative UA, and three (5%) had no UA. 60 had urine cultures (UCx): 44 (73%) grew > 100,000 CFU/ml of a potential pathogen, 13 (22%) grew < 100,000 or- ganisms, and three (5%) were contaminated. 46 residents (70%) received an antibiotic to which potential urinary pathogens were sensitive, three (5%) received antibiotics to which potential urinary pathogens were resistant, and 17 (26%) received antibiotics without sensitivity data. Twenty-nine out of 45 UCx (64%) grew organisms sensitive to ciprofloxacin. Of the 66 res- idents, 24 (37%) were prescribed FQs. 15 (23%) had a reported penicillin allergy. Conclusion/Discussion: The treatment of misdiagnosed UTIs in SN/LTCF represents a significant misuse of antibiotics. Interventions are needed to improve antibiotic treatment of UTIs in SNF/LTCFs and, in particular, to reduce treatment of ASB. Penicillin skin testing would significantly reduce the rate of residents with reported penicillin allergy and might increase the use of narrow-spectrum, first-line antibiotics. Disclosures: All authors have stated there are no financial disclosures to be made that are pertinent to this abstract. Effect of Urinalysis with Reflex Testing on Urine Culture Testing and Treatment Presenting Author: Karthik Kota, MD, MPH, University of Pittsburgh Author(s): K. Kota, J. Hwang; and J. Naumovski Introduction/Objective: Though it is a well-known fact that older patientsdparticularly women, and particularly in nursing homesdcan have bacterial colonization of their uroepithelial tract, an oft-used reflex when a patient has any change in conditiondfever, mental status change, and even urinary symptomsdis to get a urinalysis and culture. Both are often ordered simultaneously in order to practice conservatively, but this can lead to issues if a culture comes back with ambiguous results (under 100,000 colony forming units, or a non-standard organism). Here, we look at the change in number of cultures obtained and percentage of positive results against number of urinalyses ordered in one nursing home after switching to a standardized order of urinalysis with reflex in August 2017. Design/Methodology: CM is a 159-bed skilled nursing facility divided approximately equally between short-stay (IE e rehabilitation) and long- term beds, with a locked dementia unit comprising one of its four main wings. Data on urinalyses and culture resultsdas well as treatment datadare collected by the nurse educator for infectious disease review. Data from the 3 months before the switch in urine protocol was compared to the three months after. Results: There were 15 urinalyses and eight positive urine cultures in May, 13 urinalyses and 10 positive cultures in June, and 12 urinalyses and 8 pos- itive cultures in July, all before the order switch. Afterwards, there were 12 urinalyses and 9 cultures in August (8 positive), 5 urinalyses and 2 cultures in September (both positive), and 9 urinalyses with 8 cultures in October (7 positive). A similar rate of positive cultures is found before and after the order switch (65% vs 65%), with much fewer urine cultures than previous. Conclusion/Discussion: The order switch going from urinalysis with culture to urinalysis with reflex to culture did not have a significant change in the percentage of positive cultures found, but was found to involve much fewer urine cultures ordered. Using a simple change in how the default urine lab tests were ordered led to a 30% decrease in number of urine cultures ordered relative to number of urinalyses obtained. Systems changes such as this are vital to ensuring low costs in long-term care facilities, even as the demand for quality care remains robust. Implementing such a solution will help to bend the cost curve as the United States ages and more seniors require long-term care. Disclosures: All authors have stated there are no financial disclosures to be made that are pertinent to this abstract. Effects of a Story-sharing Intervention on Depression and Well-being in Older Adults Transitioning to Long-term Care Presenting Author: Gail Sullivan, PhD, MSN, ARNP-BC, CCRN, Florida Atlantic University Author(s): G.J. Sullivan Introduction/Objective: The purpose of this randomized control trial (RCT) was to investigate the effects of a story-sharing intervention on older adults transitioning to long-term care (LTC). The specific aims were (1) to determine the effects of story sharing on the health transition outcomes of depression and well-being of adults transitioning to LTC; and (2) to determine if the sociodemographic characteristics (age, gender, ethnicity, marital status, level of education (LOE), months living at LTC facility, choice to move, and health problem(s) that may have resulted in the move) predict depression and/or well-being. Story sharing was defined as the respectful space where one tells and listens to stories of others while being guided by another (the investigator). Meleis’ middle-range theory of transitions (MMRTT) was used as a guide to understand the transitioning process. A convenience sampling design was used to recruit 100 partici- pants from 11 LTC facilities in Broward County, located in Southeast Florida. Design/Methodology: This experimental study used a randomized control design to determine the effects of story sharing on health outcomes of depression and well-being in adults, age 65 years and older, who had transitioned to a LTC facility within two years. The independent variable was story-sharing intervention and the dependent variables were depression as measured by the Patient Reported Outcomes Measurement Information System (PROMISÓ) Depression Inventory (NIH, 2015), and well-being as measured by the Psychological Well-Being Scale (PWB), Satisfaction with Life Scale (SWLS), and the Scale of Positive and Negative Experience (SPANE). A convenience sample included 100 participants who were randomly assigned to the control group (n ¼ 52), who received standard care, or to the intervention group (n ¼ 41), who received story- sharing and standard care. Results: The results indicated there was no significant greater improve- ment to suggest an Intervention and Time effect for depression and/or well-being. Overall, predictive ability of the sociodemographic variables for depression and well-being were not statistically significant. However, LOE (junior college) did account for a significant portion of unique variance Research / JAMDA 19 (2018) B24eB31 B25