ArticleInfection control and hospital epidemiology2019
Effect of changing urine testing orderables and clinician order sets on inpatient urine culture testing: Analysis from a large academic medical center.
Article in Infection control and hospital epidemiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Emergency medicine physicians treating urine cultures when it is not clear they should.Clinical and experimental emergency medicine · 2026Article
- Sociodemographic disparities in antibiotic-resistant outpatient urine cultures in a Boston hospital, 2015-2020: a cross-sectional analysis.International journal for equity in health · 2024Article
- Diagnostic stewardship in infectious diseases: a scoping review.Journal of medical microbiology · 2024Article
- A decade of clinical microbiology: top 10 advances in 10 years: what every infection preventionist and antimicrobial steward should know.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Review
- What works for and what hinders deimplementation of low-value care in emergency medicine practice? A scoping review.BMJ open · 2023Article
- Prevalence and treatment of asymptomatic bacteriuria at academic and critical-access hospitals-Opportunities for stewardship efforts.Infection control and hospital epidemiology · 2023Article
- Leveraging diagnostic stewardship within antimicrobial stewardship programmes.Drugs in context · 2023Review
- Can Electronic Clinical Decision Support Systems Improve the Diagnosis of Urinary Tract Infections? A Systematic Review and Meta-Analysis.Open forum infectious diseases · 2023Article
- Applying Diagnostic Stewardship to Proactively Optimize the Management of Urinary Tract Infections.Antibiotics (Basel, Switzerland) · 2022Review
- Contrast between traditional and machine learning algorithms based on a urine culture predictive model: a multicenter retrospective study in patients with urinary calculi.Translational andrology and urology · 2022Article
- Impact of provider-selected indication requirement on urine test utilization and positivity.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2022Article
- Quality Improvement Interventions and Implementation Strategies for Urine Culture Stewardship in the Acute Care Setting: Advances and Challenges.Current infectious disease reports · 2021Article
- Deconstructing the urinalysis: A novel approach to diagnostic and antimicrobial stewardship.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2021Article
- Putting the Dissemination and Implementation in Infectious Diseases.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- Sustained decrease in urine culture utilization after implementing a reflex urine culture intervention: A multicenter quasi-experimental study.Infection control and hospital epidemiology · 2020Article
- Incidence and Diagnostic Yield of Repeat Urine Culture in Hospitalized Patients: an Opportunity for Diagnostic Stewardship.Journal of clinical microbiology · 2019Article
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7 authors.
Funding
Abstract
objectiveTo evaluate the impact of changes to urine testing orderables in computerized physician order entry (CPOE) system on urine culturing practices.
designRetrospective before-and-after study.
settingA 1,250-bed academic tertiary-care referral center. PATIENTS: Hospitalized adults who had ≥1 urine culture performed during their stay.
interventionThe intervention (implemented in April 2017) consisted of notifications to providers, changes to order sets, and inclusion of the new urine culture reflex tests in commonly used order sets. We compared the urine culture rates before the intervention (January 2015 to April 2016) and after the intervention (May 2016 to August 2017), adjusting for temporal trends.
resultsDuring the study period, 18,954 inpatients (median age, 62 years; 68.8% white and 52.3% female) had 24,569 urine cultures ordered. Overall, 6,662 urine cultures (27%) were positive. The urine culturing rate decreased significantly in the postintervention period for any specimen type (38.1 per 1,000 patient days preintervention vs 20.9 per 1,000 patient days postintervention; P < .001), clean catch (30.0 vs 18.7; P < .001) and catheterized urine (7.8 vs 1.9; P < .001). Using an interrupted time series model, urine culture rates decreased for all specimen types (P < .05).
conclusionsOur intervention of changes to order sets and inclusion of the new urine culture reflex tests resulted in a 45% reduction in the urine cultures ordered. CPOE system format plays a vital role in reducing the burden of unnecessary urine cultures and should be implemented in combination with other efforts.
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