Hospital clinical practice around urinalysis is an important opportunity for antimicrobial stewardship improvement activities.

Infection, Disease & Health
Lyn-Li Lim, Nupur Goyal

Abstract

To identify nurses' knowledge, perception and practice around urinalysis and asymptomatic bacteriuria (ASB) and to determine drivers of inappropriate urinalysis practice in an Australian hospital setting. Undertaken in eight geriatric wards over four hospitals, a questionnaire inviting voluntary, anonymous participation tested nursing staff knowledge on urinalysis, recognition of urinary tract infection (UTI) and perception of the utility of urinalysis as a routine test on all ward admissions. A retrospective one-month audit was performed on admissions to a 32-bed geriatric ward. 132 of 220 (60%) distributed surveys were completed. Performing urinalysis on all new admissions was identified as routine practice by 89%, and with indwelling catheter change by 35% of respondents. Over-three-quarters believed that routine urinalysis on admission was useful practice and up to one-third believed urinalysis abnormalities warranted antibiotic prescribing. Dark urine (57.6%), foamy urine (55.3%) and vaginal itch (34.5%) were identified as features suggestive of a UTI. In the ward audit, routine urinalysis on admission accounted for most urinalysis testing (59%, 24/41). Of occasions with clinical prompt, delirium accounted for 60% of urina...Continue Reading

References

Aug 20, 2005·Geriatric Nursing·Susan MidthunPeter Midthun
Nov 9, 2011·The Medical Journal of Australia·Rhonda L StuartTony M Korman
Feb 4, 2014·Infectious Disease Clinics of North America·Barbara W Trautner, Larissa Grigoryan
Aug 19, 2015·JAMA Internal Medicine·Penny YinJerome A Leis
Aug 8, 2017·International Journal of Antimicrobial Agents·Myrto Eleni FlokasEleftherios Mylonakis
Dec 12, 2017·Open Forum Infectious Diseases·Myrto Eleni FlokasEleftherios Mylonakis
Jul 25, 2019·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Dimitri M DrekonjaBarbara W Trautner

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