Dataset Information

Using clinical decision support to improve urine testing and antibiotic utilization.

ABSTRACT:

Objective

Urine cultures collected from catheterized patients have a high likelihood of false-positive results due to colonization. We examined the impact of a clinical decision support (CDS) tool that includes catheter information on test utilization and patient-level outcomes.

Methods

This before-and-after intervention study was conducted at 3 hospitals in North Carolina. In March 2021, a CDS tool was incorporated into urine-culture order entry in the electronic health record, providing education about indications for culture and suggesting catheter removal or exchange prior to specimen collection for catheters present >7 days. We used an interrupted time-series analysis with Poisson regression to evaluate the impact of CDS implementation on utilization of urinalyses and urine cultures, antibiotic use, and other outcomes during the pre- and postintervention periods.

Results

The CDS tool was prompted in 38,361 instances of urine cultures ordered in all patients, including 2,133 catheterized patients during the postintervention study period. There was significant decrease in urine culture orders (1.4% decrease per month; P < .001) and antibiotic use for UTI indications (2.3% decrease per month; P = .006), but there was no significant decline in CAUTI rates in the postintervention period. Clinicians opted for urinary catheter removal in 183 (8.5%) instances. Evaluation of the safety reporting system revealed no apparent increase in safety events related to catheter removal or reinsertion.

Conclusion

CDS tools can aid in optimizing urine culture collection practices and can serve as a reminder for removal or exchange of long-term indwelling urinary catheters at the time of urine-culture collection.

SUBMITTER: Yarrington ME

PROVIDER: S-EPMC10539479 | biostudies-literature | 2023 Oct

REPOSITORIES: biostudies-literature

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Publications

Using clinical decision support to improve urine testing and antibiotic utilization.

Yarrington Michael E ME Reynolds Staci S SS Dunkerson Tray T McClellan Fabienne F Polage Christopher R CR Moehring Rebekah W RW Smith Becky A BA Seidelman Jessica L JL Lewis Sarah S SS Advani Sonali D SD

Infection control and hospital epidemiology 20230329 10

<h4>Objective</h4>Urine cultures collected from catheterized patients have a high likelihood of false-positive results due to colonization. We examined the impact of a clinical decision support (CDS) tool that includes catheter information on test utilization and patient-level outcomes.<h4>Methods</h4>This before-and-after intervention study was conducted at 3 hospitals in North Carolina. In March 2021, a CDS tool was incorporated into urine-culture order entry in the electronic health record, p ...[more]

PMID: 36987849

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Dataset Information

Using clinical decision support to improve urine testing and antibiotic utilization.

Objective

Methods

Results

Conclusion

Publications

Using clinical decision support to improve urine testing and antibiotic utilization.

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