Diagnostic Stewardship Protocol to Reduce Urine Contamination: A Quality Improvement Project

Broyles, Jennifer L.; Friberg, Elizabeth; Hall, Keri K.; DeGuzman, Pamela B.

doi:10.1016/j.nurpra.2020.12.007

Cited by 3 publications

(1 citation statement)

References 11 publications

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“…Provide real-time and routine feedback to staff and leadership: a. CAUTI rates by ward 140,173 b. CAUTI rate by hospital 149,151,163 c. Hand hygiene rate 149,151 d. Catheter utilization (eg, catheter days, SUR, DUR) 108 e. Catheter care compliance 149,151 f. Costs of UTI. 163,[174][175][176][177][178]…”

Section: Evaluatementioning

confidence: 99%

Strategies to prevent catheter-associated urinary tract infections in acute-care hospitals: 2022 Update

Patel,

Advani,

Kofman

et al. 2023

Infect. Control Hosp. Epidemiol.

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and purposeThe intent of this document is to highlight practical recommendations in a concise format designed to assist physicians, nurses, and infection preventionists at acute-care hospitals in implementing and prioritizing their catheter-associated urinary tract infection (CAUTI) prevention efforts. This document updates the Strategies to Prevent Catheter-Associated Urinary Tract Infections in Acute-Care Hospitals published in 2014. It is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the Association for Professionals in Infection Control and Epidemiology (APIC), the American Hospital Association (AHA), and The Joint Commission.

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Section: Evaluatementioning

confidence: 99%

Strategies to prevent catheter-associated urinary tract infections in acute-care hospitals: 2022 Update

Patel,

Advani,

Kofman

et al. 2023

Infect. Control Hosp. Epidemiol.

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Diagnostic stewardship in infectious diseases: a scoping review

Shorten,

Pickering,

Goolden

et al. 2024

Journal of Medical Microbiology

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Introduction. The term ‘diagnostic stewardship’ is relatively new, with a recent surge in its use within the literature. Despite its increasing popularity, a precise definition remains elusive. Various attempts have been made to define it, with some viewing it as an integral part of antimicrobial stewardship. The World Health Organization offers a broad definition, emphasizing the importance of timely, accurate diagnostics. However, inconsistencies in the use of this term still persist, necessitating further clarification. Gap Statement. There are currently inconsistencies in the definition of diagnostic stewardship used within the academic literature. Aim. This scoping review aims to categorize the use of diagnostic stewardship approaches and define this approach by identifying common characteristics and factors of its use within the literature. Methodology. This scoping review undertook a multi-database search from date of inception until October 2022. Any observational or experimental study where the authors define the intervention to be diagnostic stewardship from any clinical area was included. Screening of all papers was undertaken by a single reviewer with 10% verification by a second reviewer. Data extraction was undertaken by a single reviewer using a pre-piloted form. Given the wide variation in study design and intervention outcomes, a narrative synthesis approach was applied. Studies were clustered around common diagnostic stewardship interventions where appropriate. Results. After duplicate removal, a total of 1310 citations were identified, of which, after full-paper screening, 105 studies were included in this scoping review. The classification of an intervention as taking a diagnostic stewardship approach is a relatively recent development, with the first publication in this field dating back to 2017. The majority of research in this area has been conducted within the USA, with very few studies undertaken outside this region. Visual inspection of the citation map reveals that the current evidence base is interconnected, with frequent references to each other’s work. The interventions commonly adopt a restrictive approach, utilizing hard and soft stops within the pre-analytical phase to restrict access to testing. Upon closer examination of the outcomes, it becomes evident that there is a predominant focus on reducing the number of tests rather than enhancing the current test protocol. This is further reflected in the limited number of studies that report on test performance (including protocol improvements, specificity and sensitivity). Conclusion. Diagnostic stewardship seems to have deviated from its intended course, morphing into a rather rudimentary instrument wielded not to enhance but to constrict the scope of testing. Despite the World Health Organization’s advocacy for an ideology that promotes a more comprehensive approach to quality improvement, it may be more appropriate to consider alternative regional narratives when categorizing these types of quality improvement interventions.

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The foundation for the microbiology laboratory’s essential role in diagnostic stewardship: an ASM Laboratory Practices Subcommittee report

Dumm,

Marlowe,

Patterson

et al. 2024

J Clin Microbiol

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Diagnostic stewardship (DxS) has gained traction in recent years as a cross-disciplinary method to improve the quality of patient care while appropriately managing resources within the healthcare system. Clinical microbiology laboratorians have been highly engaged in DxS efforts to guide best practices with conventional microbiology tests and more recently with molecular infectious disease diagnostics. Laboratories can experience resistance to their role in DxS, especially when the clinical benefits, motivations for interventions, and underlying regulatory requirements are not clearly conveyed to stakeholders. Clinical laboratories must not only ensure ethical practices but also meet obligatory requirements to steward tests responsibly. In this review, we aim to support clinical microbiology laboratorians by providing the background and resources that demonstrate the laboratory’s essential role in DxS. The heart of this review is to collate regulatory and accreditation requirements that, in essence, mandate DxS practices as a long-standing, core element of high-quality laboratory testing to deliver the best possible patient care. While examples of the clinical impact of DxS are plentiful in the literature, here, we focus on the operational and regulatory justification for the laboratory’s role in stewardship activities.

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Diagnostic Stewardship Protocol to Reduce Urine Contamination: A Quality Improvement Project

Cited by 3 publications

References 11 publications

Strategies to prevent catheter-associated urinary tract infections in acute-care hospitals: 2022 Update

Strategies to prevent catheter-associated urinary tract infections in acute-care hospitals: 2022 Update

Diagnostic stewardship in infectious diseases: a scoping review

The foundation for the microbiology laboratory’s essential role in diagnostic stewardship: an ASM Laboratory Practices Subcommittee report

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