Highlights
- •Urine culture specimens are collected from many catheterised patients despite there being no apparent clinical indication.
- •A decision support tool was developed to inform appropriate urine specimen collection for catheterised patients.
- •In an acute aged care setting this tool resulted in a significant reduction in urine specimen collection and catheter use.
Abstract
Background
The culture of a urine specimen is one of the most common diagnostic investigations
undertaken in the acute care environment. However, often urine specimen collection
and culture is unnecessary, clinically inappropriate, leads to substantial over treatment
and is a wasteful use of pathology. Furthermore urine specimen collection from patients
with urinary catheters presents an opportunity for microorganisms to colonise the
drainage system and cause clinical infection. Unnecessary specimen collection can
also drive inappropriate antimicrobial use.
A new decision support tool was developed to inform clinically appropriate urine specimen
collection and culture for patients with urinary catheters. The aim of this study
was to test the effect and practicality of this tool in an acute aged care setting.
Methods
Specimen collection, catheter utilisation and infection rates were collected for eight
weeks pre- and post-implementation of the tool. Implementation of the tool was carried
out for four weeks and included the provision of targeted nursing and medical education.
Results
The collection of catheter specimen urine (CSU) specimens and all urine specimens
reduced after the implementation of the tool. Implementation of the new tool was also
associated with a significant reduction in catheter days and catheter utilisation.
Conclusion
Implementation of the new decision support tool, together with the provision of targeted
education, was associated with reducing the number of urine specimens collected and
catheter dwell times in the unit.
Keywords
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Article info
Publication history
Published online: January 09, 2017
Accepted:
December 15,
2016
Received in revised form:
December 15,
2016
Received:
October 31,
2016
Identification
Copyright
© 2016 Australasian College for Infection Prevention and Control. Published by Elsevier B.V. All rights reserved.
