Journal article
Healthcare worker attitudes on routine non-urological preoperative urine cultures: a qualitative assessment
Infection control and hospital epidemiology, Vol.45(10), pp.1156-1161
10/2024
DOI: 10.1017/ice.2024.85
PMCID: PMC11611506
PMID: 39297374
Appears in UI Libraries Support Open Access
Abstract
Objective:
Many preoperative urine cultures are of low value and may even lead to patient harms. This study sought to understand practices around ordering preoperative urine cultures and prescribing antibiotic treatment.
Design:
Open-ended, semi-structured qualitative interviews
Setting:
5 Veterans Affairs hospitals.
Participants:
Interviews with 14 surgeons (9 surgeons, 5 surgical leaders), 7 infectious disease physicians, 8 surgical advanced practice providers (APPs), 1 surgical nurse manager, 3 infectious disease pharmacists, 1 hospitalist, and 1 lab manager.
Methods:
We interviewed participants using a qualitative semi-structured interview guide. Collected data was coded inductively and with the Dual Process Model (DPM) using MAXQDA software. Data in the “Testing Decision-Making” code was further reviewed using the concept of perceived risk as a sensitizing concept.
Results:
We identified themes relating to surgeons’ concerns about de-implementing preoperative urine cultures to detect asymptomatic bacteriuria (ASB) in patients undergoing non-urological procedures: (1) anxiety and uncertainty surrounding missing infection signs spanned surgical specialties, (2) there were perceived risks of negative consequences associated with omitting urine cultures and treatment prior to specific procedure sites and types, and additionally, (3) participants suggested potential routes for adjusting these perceived risks to facilitate de-implementation acceptance. Notably, participants suggested that leadership support and peer engagement could help improve surgeon buy-in.
Conclusions:
Concerns about perceived risks sometimes outweigh the evidence against routine preoperative urine cultures to detect ASB. Evidence from trusted peers may improve openness to de-implementing preoperative urine cultures.
Details
- Title: Subtitle
- Healthcare worker attitudes on routine non-urological preoperative urine cultures: a qualitative assessment
- Creators
- Julia E Friberg Walhof - University of IowaMarin L Schweizer - University of Wisconsin–MadisonKalpana Gupta - VA Boston Healthcare SystemMadisen Brown - VA Boston Healthcare SystemDaniel Suh - Iowa City VA Health Care SystemJudith Strymish - VA Boston Healthcare SystemWilliam J O'Brien - VA Boston Healthcare SystemJeffrey Chan - VA Boston Healthcare SystemKelly Miell - Iowa City VA Health Care SystemVanessa Au - Iowa City VA Health Care SystemBarbara W Trautner - Baylor College of MedicineKimberly C Dukes - Iowa City VA Health Care System
- Resource Type
- Journal article
- Publication Details
- Infection control and hospital epidemiology, Vol.45(10), pp.1156-1161
- DOI
- 10.1017/ice.2024.85
- PMID
- 39297374
- PMCID
- PMC11611506
- NLM abbreviation
- Infect Control Hosp Epidemiol
- ISSN
- 1559-6834
- eISSN
- 1559-6834
- Publisher
- Cambridge University Press
- Grant note
- US Department of Veterans Affairs Health Services Research and Development Service: IIR 18-057 US Department of Veterans Affairs Health Services Research and Development Service at the Center for Innovations in Quality, Effectiveness, and Safety: CIN 13-413)
This work was funded by the US Department of Veterans Affairs Health Services Research and Development Service (grant no. IIR 18-057; PIs: KG and MLS).BWT's work is supported in part by the US Department of Veterans Affairs Health Services Research and Development Service (grant no. CIN 13-413) at the Center for Innovations in Quality, Effectiveness, and Safety.
- Language
- English
- Electronic publication date
- 09/19/2024
- Date published
- 10/2024
- Academic Unit
- Epidemiology; General Internal Medicine; Community and Behavioral Health; Internal Medicine
- Record Identifier
- 9984719268302771
Metrics
38 Record Views