Lessons from audit and feedback of hospitalized patients with bacteriuria

Jerome A Leis; Lesley Palmay; Marion Elligsen; Sandra A N Walker; Colin Lee; Nick Daneman

doi:10.1016/j.ajic.2014.06.020

Lessons from audit and feedback of hospitalized patients with bacteriuria

Am J Infect Control. 2014 Oct;42(10):1136-7. doi: 10.1016/j.ajic.2014.06.020.

Authors

Jerome A Leis¹, Lesley Palmay², Marion Elligsen², Sandra A N Walker³, Colin Lee², Nick Daneman⁴

Affiliations

¹ Division of Infectious Diseases, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; Centre for Quality Improvement and Patient Safety, University of Toronto, Toronto, ON, Canada. Electronic address: [email protected].
² Department of Pharmacy, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
³ Division of Infectious Diseases, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; Department of Pharmacy, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.
⁴ Division of Infectious Diseases, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; Centre for Quality Improvement and Patient Safety, University of Toronto, Toronto, ON, Canada.

PMID: 25278413
DOI: 10.1016/j.ajic.2014.06.020

Abstract

We sought to prevent the initiation of antimicrobial therapy for asymptomatic bacteriuria (ASB) by providing audit and feedback of newly reported positive urine cultures to test whether this could empower providers to leave ASB untreated. Despite success in providing feedback before antibiotics could be initiated in most cases, these recommendations only reduced treatment duration, without affecting antibiotic initiation. This study highlights the limitations of educational initiatives in overcoming engrained beliefs about bacteriuria even when advice is provided in real time.

Keywords: Asymptomatic bacteriuria; Quality improvement; Urine culture.

MeSH terms

Adult
Aged
Anti-Bacterial Agents / therapeutic use*
Asymptomatic Diseases / therapy*
Bacteriuria / diagnosis*
Bacteriuria / drug therapy*
Drug Utilization*
Female
Health Services Research
Humans
Male
Urine / microbiology*

Substances

Anti-Bacterial Agents