Major articleA survey of resident physicians' knowledge regarding urine testing and subsequent antimicrobial treatment
Section snippets
Subjects
Potential subjects were resident physicians in internal medicine and medicine–pediatrics at 2 publically funded medical schools, the Jackson Memorial Hospital/University of Miami Miller School of Medicine and the University of Minnesota Medical School. To reach this population, we obtained e-mail addresses for all resident physicians enrolled in these training programs as of July 1, 2011 (University of Miami n = 137, University of Minnesota n = 143). Each resident received an e-mail notifying
Results
Invitations were sent to 280 resident physicians, including 207 internal medicine residents, 60 medicine–pediatrics residents, and 13 chief residents, resulting in 100 total responses (36% response rate). There were 42 respondents from the University of Miami and 58 from the University of Minnesota. Respondents were 51% male, with a mean ± SD age of 29 ± 3 years. Most (n = 76) were internal medicine residents (including 5 chief residents), with the remaining 24 being medicine–pediatrics
Discussion
In our survey of internal medicine and medicine–pediatrics resident physicians, which we believe is the first study to address resident physicians' knowledge regarding urine testing and subsequent management, we documented that knowledge was poor overall, with the mean percentage of correct answers being below 50%. Knowledge did not vary significantly in relation to self-reported experience managing UTIs, having had an infectious disease rotation, or any of the assessed demographic factors,
Conclusions
Our multisite survey of internal medicine and medicine–pediatric resident physicians demonstrates that trainee knowledge regarding urine testing and subsequent treatment is suboptimal, and does not vary significantly with training level, experience in UTI management, or exposure to IDSA guidelines or an infectious disease rotation. Our findings correspond with the common practice of treating ASB as a clinically significant UTI,1, 2, 3 which suggests that our results are not simply testing
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2020, American Journal of Infection ControlPromoting appropriate urine culture management to improve health care outcomes and the accuracy of catheter-associated urinary tract infections
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2017, Infection, Disease and HealthCitation Excerpt :Without strict adherence to aseptic technique and correct collection technique, specimen collection can potentially contaminate the drainage system and promote the establishment of a catheter-associated urinary tract infection (CAUTI) [11]. There is substantiated concern for this risk given that approximately 10% of nursing staff do not adhere to correct practices for specimen collection [8], and there is poor knowledge among medical staff on the clinical indications for urine culture [12]. Secondly, the internal surface of the IDC is inevitably colonized by biofilm over time.
Survey finds improvement in cognitive biases that drive overtreatment of asymptomatic bacteriuria after a successful antimicrobial stewardship intervention
2016, American Journal of Infection ControlCitation Excerpt :Thus, we believe that increased knowledge and attitude change of the providers were the underlying mechanism influencing the effectiveness of our intervention, although we cannot directly link improvements on the survey to behavior change. Our study is in line with other studies showing that lack of knowledge of guidelines and misconceptions of what the guidelines recommend (ie, cognitive biases) are barriers for evidence-based care of ASB.12-15 Other intervention-based studies have decreased antibiotic overuse for ASB by using education, pocket cards, audit and feedback, and computer-based reminders.18-25
How and when nurses collect urine cultures on catheterized patients: A survey of 5 hospitals Previous Presentations: Presented at the 2014 APICAnnual Conference, June 7-9, 2014, Anaheim, CA (poster no. 5-178).
2016, American Journal of Infection ControlCitation Excerpt :On the other hand, optimizing the nurse's knowledge of when urine cultures are indicated is essential to curbing inappropriate urine culture use in the hospital setting. Similar knowledge gaps also exist for physicians.21,22 The current health care environment dictates a collaborative relationship between nurses and physicians to promote culturing stewardship and, subsequently, to reduce unnecessary antimicrobial use and the potential unexpected effect of National Healthcare Safety Network–defined CAUTI events.23
Approach to a positive urine culture in a patient without urinary symptoms
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This study was supported by the resources of the Minneapolis Veterans Affairs Health Care System, including the Center for Epidemiological and Clinical Research.
Conflicts of interest: J.R.J. has research grants or contracts with Merck, Rochester Medical, and Syntiron.