Promoting Timely and Appropriate Symptom-Based Urine Culture Testing to Reduce CAUTI Rates
Presentation ID #05: Click here to view presentation.
Purpose: The purpose of this integrated review was to determine if timely and symptom-based urine culture testing reduced the rate of catheter associated urinary tract infections (CAUTIs) in acute care patients with indwelling urinary catheters.
Background: Too often urinalysis is ordered with reflex culture or panculturing is performed when the patient has no specific signs of a urinary tract infection as part of a routine workup. Unnecessary ordering of reflex cultures or panculturing often results in assignment of an unnecessary CAUTI and improper utilization of antibiotics in an age of antimicrobial resistance when there is not a true infection, and instead colonization of bacteria. Unnecessary culturing can also lead to delayed diagnosis of true infections and late or improper treatment.
Methods: Databases were searched based on specific terminology and included or excluded based upon relevance, timeframe, research design, setting, and duplicates. Databases searched included PubMed, CINAHL, and ProQuest.
Results: Review of multiple articles showed that ordering timely and symptom-based urine cultures reduced overall incident rates of CAUTIs, indwelling urinary catheter use, length of patient stay and overuse of antibiotics. Research supports symptom-based urine cultures to identify true infection over testing urine based on changes in objective qualities (color, odor, sediment) or seeing what grows in various specimens known as panculturing.
Conclusion: Appropriate symptom-based urine culturing leads to a lower incidence of CAUTIs and decreased number of urine cultures ordered, while also decreasing urinary catheter utilization rates and lowering antibiotic usage.
LeAnn Martin, BS, RN, PHN is the Public Health Nurse Supervisor of a three county district health department in Western NC, know as AppHealthCare. LeAnn earned her Bachelor’s in Public Health from the University of North Carolina at Greensboro in 2016 and her ADN from Virginia Highlands Community College in 2020. She is a member of the North Carolina Public Health Association, chairing the Epidemiology/Lab/Statistics section and a member of North Carolina Association of Public Health Nurse Administrator’s.
Jocelyn Tranum, BSN, RN, CCRN is the Nurse Manager of an Intermediate Critical Care Unit at Novant Health Forsyth Medical Center, a tertiary care facility in Winston Salem, NC. Jocelyn earned her BSN from the University of North Carolina at Wilmington in 2018 and her ADN from Guilford Technical Community College in 2014. She maintains a Critical Care Registered Nurse certification through the American Association of Critical Care Nurses, is a member of the Nu Omega chapter of Sigma Theta Tau at the University of North Carolina at Wilmington, a member of the American Nurses Association, and a member of the North Carolina Nurses Association.
Heather Wenzel, BSN, RN, CCRN, SCRN is the Nurse Manager of Neuroscience Intensive Care Unit at Novant Forsyth Medical Center, a tertiary Comprehensive Stroke Center in Winston Salem NC. Heather earned her BSN from the University of North Carolina at Charlotte in 2009. She currently holds her Stroke Certified Registered Nurse through the American Board of Neuroscience Nursing and her Critical Care Registered Nurse through the American Association of Critical Care Nurses. She is a member of Sigma Theta Tau Gamma Iota Chapter, American Association of Critical Care Nurses, American Board of Neuroscience Nursing, and American Association of Neuroscience Nurses.