Description
At Trios Health, the prevalence of ASB is significantly higher than other hospitals in our cohort. We have implemented order set changes with the goal of reducing the identification of ASB in patient’s that do not require treatment. The secondary goal would be to reduce workload for lab by decreasing the number of urine cultures.
Data Collection:
Weekly chart review using a custom report in Labcorp and randomly select 5 cultures to enter (goal: 5 cultures/week).
SMART Goal #3:
A review of Trios order sets has revealed several containing unnecessary orders for UA and urine culture, often pre-checked. After removing the unnecessary UA/Urine culture orders from the order sets and removing certain pre-checks, we will continue to collect data via the Redcap survey through July of 2025 in order to evaluate the effectiveness of the changes that have been made. Our goal will be to reduce ASB prevalence to 40%.
Project Resources
Core Elements
Reporting
Regular reporting information on antibiotic use and resistance to doctors, nurses and relevant staff.
Tracking
Monitoring antibiotic prescribing and resistance patterns.
PDSA Cycles
Progress on PDSA Cycle 1
- Data Collection
- I will continue to collect data weekly (goal is 5 cases per week) in order to evaluate for a reduction in ASB prevalence as well as inappropriate diagnosis of UTI
- I have already seen a dramatic reduction in the number of urinalysis and urine cultures sent (diagnostic stewardship) and hope that this results in fewer cases of ASB being treated as well
Observations:
Throughout the IQIC project, we have reported results to the antimicrobial stewardship committee on a quarterly basis. I will be presenting the following at the 2nd quarter 2025 meeting:
- Information from the latest data report.
- Raw numbers of UA and Urine cultures processed from January-March 2025.
We will be reviewing our latest data and analyze trends to see if we have made any more progress.
We are currently working on a new UTI order set that has been presented at the last antimicrobial stewardship meeting on 8/20/25. The goal would be to go live with the new order set by 10/31/25.
I am also working on a presentation for the ED providers that will update them on our ASB project and encourage shorter durations of therapy when treating UTI as well as not treating ASB.