Reducing Hospital-Acquired Urinary Tract Infections Through Diagnostic Stewardship Interventions

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Publication Date

7-23-2025

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Presentation: 47:05

Abstract

Inappropriate utilization of diagnostic tests is a significant problem in healthcare and can lead to several negative impacts which diminish the quality and safety of healthcare delivery. Inappropriate testing and inaccurate interpretation of infectious disease diagnostic testing lead to unnecessary antimicrobial use and inaccurate attribution of healthcare-associated infections. Urinary tract infections are one of the most common infections diagnosed in hospitalized patients, but the accuracy of these diagnoses is low, and opportunities exist to improve the utilization of urine cultures to reduce inaccurate attribution of asymptomatic bacteriuria as urinary tract infection. Diagnostic stewardship is a burgeoning field that aims to improve the ordering, performance, and interpretation of diagnostic tests to improve clinical decision making. Jefferson Einstein Philadelphia implemented a new urinalysis with reflex to urine culture workflow along with required documentation of signs/symptoms of urinary tract infection to promote appropriate ordering and improve accuracy of urine studies in the workup of UTI. Over 2 years, the project decreased the total utilization of urine cultures by 35% and reduced the CAUTI standardized infection ratio from 2.237 to 0.851. Diagnostic stewardship interventions improved the appropriate ordering of urine studies and were well accepted by frontline staff without any identified harm to patients.

Language

English

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