Reducing unnecessary urine culture testing in residents of long term care facilities

What you need to knowAsymptomatic bacteriuria is a positive result from a urine culture test in the absence of minimum symptoms of urinary tract infection, and is present in 30-50% of residents in long term care homesIndiscriminate testing leads to detection of asymptomatic bacteriuria and prompts unnecessary antibiotic treatmentStrategies to reduce unnecessary urine cultures include targeted education supported by system changes such as modification of order sets and routine panels, elimination of urine dipsticks, and changes to laboratory processing and reportingAn older woman with moderate stage dementia living in a long term care home has new confusion and slurred speech. Her nurse notes an “unusual smell” while collecting a urine specimen and sends it for culture testing to the microbiology laboratory. The care home physician is notified that afternoon of the clinical finding and performs a focused examination, which is unremarkable, and then signs off the urine culture order. The…
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