Limiting Waste: Reducing Urine Culture Testing in Inpatients

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Presentation: 45:54


To reduce waste and improve antibiotic stewardship, the ABIM Foundation’s Choosing Wisely Campaign and The Infectious Diseases Society of America recommend against screening and treating for suspected urinary tract infections (UTI) unless patients are symptomatic or meet specific clinical parameters. However, ordering a urine culture in patients with no urinary symptoms or appropriate indication is still prevalent. A retrospective chart review in this study on two general medical wards revealed that 60% of urine cultures collected were inappropriate. Reasons included reflexive testing for fever and sepsis workup and lack of clinician awareness of correct indications for testing. This project aimed at reducing the inappropriate collection of urine cultures in asymptomatic patients in the inpatient setting using a multifaceted approach. The Model for Improvement tool was used to develop, test, and implement change. Interventions include implementing a urine culture ordering algorithm, restricting orders in the electronic medical record, front-line provider education, and empowering nurses using existing institutional tools.



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