Changing the culture of urine culturing: Utilizing Agile Implementation to improve diagnostic stewardship in the ICU

Abstract

Over diagnosis of catheter-associated urinary tract infection (CAUTI) contributes to unnecessary and excessive antibiotic use, selection for resistant organisms, increased risk for Clostridiodes difficile infections, as well as a false elevation in CAUTI rates. Utilizing agile implementation to implement a urine culture algorithm achieved statistically significant reduction in CAUTI rates in a critical care unit resulting in sustainment and spread throughout the system.

Keywords: Catheter associated urinary tract infection; Implementation science; Quality improvement.