Impact of provider-selected indication requirement on urine test utilization and positivity

Author:

Penney Jessica A.ORCID,Rodday Angie Mae,Sebastiani PaolaORCID,Snydman David R.,Doron Shira I.ORCID

Abstract

Abstract Objective: To evaluate the impact of the addition of an indication specification requirement to isolated urine-culture ordering on testing utilization. Design: Retrospective study utilizing interrupted time series analysis with negative binomial regression. The preintervention period was October 1, 2018–November 11, 2019, and the postintervention period was November 12, 2019–October 31, 2020. The primary outcome was isolated culture rate per 1,000 patient days. Secondary outcomes were the proportion of all urine tests ordered as isolated urine culture and culture positivity. An exploratory analysis assessed the appropriateness of selected testing indications. Setting: A 415-bed, urban, academic medical center. Patients: Adult patients with urine testing performed during hospital admission. In total, 1,494 unique isolated urine-culture orders were included in the analysis. Interventions: On November 12, 2019, the laboratory order interface was changed to require the ordering provider to select an indication for isolated urine culture. Results: Isolated urine-culture rates did not significantly change after the intervention (11.2–7.8 cultures per 1,000 patient days; P = .17) nor did culture positivity (26.9% vs 26.8%). Most ordering providers left the indication for testing blank, and of those charts reviewed, 67% did not have a documented condition for which isolated urine culture was the most appropriate initial test. Conclusions: The addition of an order-specification requirement for isolated urine-culture testing did not significantly affect ordering practices. The test remains overused as the initial diagnostic evaluation for a suspected urinary tract infection. Further provider education and continued changes in provider workflow are needed to achieve lasting change in practice.

Publisher

Cambridge University Press (CUP)

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3