i
Effect of changing urine testing orderables and clinician order sets on inpatient urine culture testing: Analysis from a large academic medical center
-
3 2019
-
-
Source: Infect Control Hosp Epidemiol. 40(3):281-286
[PDF-519.90 KB]
Details:
-
Alternative Title:Infect Control Hosp Epidemiol
-
Personal Author:
-
Description:Objective:
To evaluate the impact of changes to urine testing orderables in computerized physician order entry (CPOE) system on urine culturing practices.
Design:
Retrospective before (January 2015 to April 2016) and after (May 2016 to August 2017) study.
Setting:
A 1,250-bed academic tertiary referral center.
Patients:
Hospitalized adults who had ≥1 urine culture performed during their stay.
Intervention:
The 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 and after intervention, adjusting for temporal trends.
Results:
During the study period, 18,954 inpatients (median age 62 years, 68.8% white and 52.3% female) had 24,569 urine cultures ordered. Twenty-seven percent (n=6642) of the urine cultures were positive. Urine culturing rate decreased significantly in the post-intervention period for any specimen type (38.1 pre-vs. 20.9 per 1000 patient days post-intervention, p<0.001), clean catch (30.0 vs. 18.7, p<0.001) and catheterized urine (7.8 vs. 1.9, p<0.001). Using an interrupted time series model, urine culture rates decreased for all specimen types (p<0.05).
Conclusions:
Our 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.
-
Keywords:
-
Source:
-
Pubmed ID:30786940
-
Pubmed Central ID:PMC6433134
-
Document Type:
-
Funding:
-
Collection(s):
-
Main Document Checksum:
-
Download URL:
-
File Type:
