N/A
N=1,598
Asymptomatic Bacteriuria Guideline Implementation Study
Infection Due to Indwelling Urinary Catheter · Asymptomatic Bacteriuria
Bottom Line
View on ClinicalTrials.gov: NCT01052545 ↗Enrolled (actual)
1,598
Serious AEs
—
Results posted
Nov 2014
Primary outcome: Primary: Number of Cases of ABU That Are Treated Inappropriately With Antibiotics — 1.6; 0.6; 0.5; 0.6 cases/1,000 bed-days
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- Audit-Feedback (Behavioral)
- Age
- Pediatric, Adult, Older Adult
- Sex
- All
- Sponsor
- VA Office of Research and Development
- Primary completion
- Jun 2013
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Number of Cases of ABU That Are Treated Inappropriately With Antibiotics |
1.6; 0.6; 0.5; 0.6; 0.4; 0.5 | — |
| PRIMARY Urine Cultures Ordered |
41.2; 49.3; 23.3; 54.4; 12.0; 46.6 | <0.05 sig |
| PRIMARY Number of Cases of CAUTI Inappropriately Under-treated (no Antibiotics Given) |
0.2; 0.1; 0.1; 0.2; 0.05; 0.07 | — |
| SECONDARY Number of Days Antibiotics Are Given to Treat ABU |
— | — |
| SECONDARY Clinicians' Awareness of and Familiarity With the ABU Guidelines. |
151; 62; 150 | — |
| SECONDARY Clinicians Acceptance of and Outcome Expectancy From Following the ABU Guidelines |
3.0; 3.2; 3.3 | — |
| SECONDARY Number of Catheter-days of Use Per 1000 Patient Bed Days on Each Unit |
347.2; 392.1 | — |
| SECONDARY Patient Level Analysis of Inappropriate Antibiotic Use |
38; 20; 22; 25; 29; 17 | <0.05 sig |
Summary
Overtreatment of asymptomatic bacteriuria (ABU) is a quality, safety, and cost issue, particularly as unnecessary antibiotics lead to emergence of resistant pathogens. The investigators' proposal to bring clinical practice in line with published guidelines has significant potential to reduce unnecessary antibiotic use for ABU in the VA healthcare system, thus improving the quality and safety of veterans' healthcare. The investigators' study will also provide important insights about how to implement and sustain evidence-based clinical practice within VA hospitals.
Eligibility Criteria
Inclusion Criteria
- For Objective 1 (Clinical Outcomes), all inpatients at the MEDVAMC or STVHCS on the units of interest (medicine or ECL) during the 3 year period of the study will be included in the chart review process.
- For Objective 2, modifying health care provider knowledge and behavior through audit-feedback and surveys, the investigators will attempt to involve all health care providers on rotation at the VA on the targeted wards during the study period.
- The audit-feedback intervention will be applied to the health care providers on the targeted wards who make the decision to treat CAUTI.
Exclusion Criteria
- None.
- For the chart review component, the investigators want to capture all available data about the clinical outcomes during the study period.
- review the inpatient rosters on the wards of interest several times per week to determine how many of the patients have urinary catheters, etc.
- survey as many health care providers as possible who rotate on the wards of interest during the study period.
- the investigators anticipate that all health care providers who work at the VA hospital will be competent to provide or refuse consent to participate.
Data sourced from ClinicalTrials.gov (NCT01052545). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.