Unnecessary UTI testing cut by 45%

Editor's Note

Making a simple change to the electronic system used by physicians to order urine tests can cut by 45% the number of bacterial cultures ordered without compromising the identification of patients who need treatment for urinary tract infections (UTIs), this study finds.

In this analysis of 18,954 patients who had 24,569 urine cultures ordered, 6,662 urine cultures (27%) were positive. 

Researchers at Barnes-Jewish Hospital, St Louis, compared all urine culture tests ordered in the 15 months before changing the electronic order set to a urine dipstick test first followed by a culture rather than a culture alone to 15 months after.

Before the change, physicians ordered 15,746 cultures (38.1 orders per 1,000 patient days). After the change, they ordered 8,823 cultures (20.9 orders per 1,000 patient days), a significant decrease.

The number of cultures for patients with catheters dropped significantly from 7.8 to 1.9 per 1,000 patient days, with no change in the number of catheter-associated UTIs (125 patients in each time period).

The intervention saved approximately $104,000 in laboratory costs alone during the time period.