SHM Converge Scientific Abstract ePoster Gallery-Reducing Inappropriate Treatment of Asymptomatic Bacteriuria in Critical Access Hospitals

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This study examined whether the ID-UTI quality measure could help reduce inappropriate antibiotic treatment of asymptomatic bacteriuria (ASB) in Critical Access Hospitals (CAHs), which often have fewer stewardship resources than larger hospitals.<br /><br />Ten CAHs across five U.S. states participated in an Intensive Quality Improvement Cohort from October 2022 to July 2023. The intervention included three parts: education sessions, individualized coaching, and performance feedback reports based on the ID-UTI measure. Hospitals submitted deidentified clinical data on patients with positive urine cultures who were evaluated in the emergency department and treated with antibiotics. A total of 608 cases were abstracted.<br /><br />Most patients were older adults, female, and seen in the emergency department and discharged. The study evaluated change in ASB treatment over time and compared it with two control outcomes: avoidable fluoroquinolone use and antibiotic duration.<br /><br />Findings showed that the CAHs were able to collect usable data for the measure despite limited stewardship infrastructure, non-physician stewardship champions, multiple electronic medical records, and variable abstraction capacity. Use of the ID-UTI measure within the quality improvement program was associated with a 34.5% decline in ASB treatment, but this decrease was not statistically significant. The control outcomes did not change.<br /><br />Overall, the study suggests that the ID-UTI measure can be implemented in CAHs and may help reduce inappropriate ASB treatment, though larger studies are needed to confirm effectiveness.

Asset Subtitle

Claire Ciarkowski

Meta Tag

Author List Adam Hersh, Andrea White, Chaorong Wu, Chloe Bryson-Cahn, Claire Ciarkowski, Hannah Imlay, Jeannie Chan, John Lynch, Natalia Martinez-Paz, Valerie M. Vaughn, Whitney Hartlage, Zahra Kassamali Escobar

Category Research

Concept Asymptomatic Bacteriuria

Concept Overuse

Concept Critical Access Hospital

Concept ID-UTI Measure

Concept Quality Improvement Intervention

Distinguished Non-Finalist

Presenter Organization University of Utah Health

Presenting Author Claire Ciarkowski

Track Quality Improvement

Keywords

ID-UTI quality measure

asymptomatic bacteriuria

critical access hospitals

antibiotic stewardship

quality improvement

emergency department

inappropriate antibiotic treatment

fluoroquinolone use

electronic medical records

clinical data abstraction

Asymptomatic Bacteriuria

Overuse

Critical Access Hospital

ID-UTI Measure

Quality Improvement Intervention