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Improving a Urine Culture Callback Follow-up System in a Pediatric Emergency Department

Patrick Burchett, Scott Harpin, Ann Petersen-Smith

    Journal of Pediatric Health Care : Official Publication of National Association of Pediatric Nurse Associates & Practitioners
    |July 26, 2015
    PubMed

    Insights

    A quality improvement project reduced urinary tract infection (UTI) lab result follow-up time by 64.7% and increased antibiotic discontinuation notifications by 8.4x. This enhances patient safety and combats antibiotic resistance.

    Area of Science:

    • Quality Improvement
    • Pediatric Emergency Medicine
    • Infectious Disease Management

    Background:

    • Urinary tract infections (UTIs) pose risks of adverse events and antibiotic resistance due to treatment delays and overuse.
    • Effective management requires timely results and appropriate antibiotic discontinuation.

    Purpose of the Study:

    • To decrease emergency department laboratory result follow-up time for UTIs.
    • To increase patient notification for discontinuing empiric antibiotics when cultures are negative.

    Main Methods:

    • Utilized nine months of Plan-Do-Study-Act (PDSA) cycles in a pediatric emergency department.
    • Compared three months of baseline data with three months of post-intervention data.

    Main Results:

    • Reduced time to laboratory follow-up from 20.1 hours to 7.1 hours (64.7% decrease).
    • Increased notification to discontinue antibiotics for negative cultures from 8.8% to 74.4%.

    Conclusions:

    • A culture callback system staffed by advanced practice providers significantly improved UTI management.
    • The intervention reduced follow-up time and increased appropriate antibiotic discontinuation.
    Abstract

    Keywords:
    Pediatricsemergency medicinequality improvementurinary tract infection

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