Clinical decision support menu for reducing unnecessary urine cultures

Area of Science:

• Clinical microbiology
• Healthcare informatics
• Diagnostic stewardship

Background:

• Unnecessary urine culture (UC) testing contributes to antimicrobial resistance and healthcare costs.
• Effective diagnostic stewardship strategies are needed to optimize laboratory test utilization.

Purpose of the Study:

• To evaluate the impact of a clinical decision support (CDS) menu on UC sample collection.
• To assess the effectiveness of requiring UC indication selection for improving diagnostic stewardship.

Main Methods:

• Implementation of a CDS menu in outpatient and inpatient settings.
• Mandatory selection of a UC indication prior to ordering.
• Audit of UC sample collection rates and documentation quality post-intervention.

Main Results:

• Significant reduction in UC sample collection rates observed after CDS implementation.
• Clear documentation of selected UC indications in the majority of post-intervention cases.
• Demonstrated feasibility of the CDS tool in a large integrated health care system.

Conclusions:

• A CDS menu requiring UC indication selection is an effective diagnostic stewardship strategy.
• This approach can significantly reduce unnecessary laboratory test utilization.
• Improved documentation supports appropriate test ordering and antimicrobial stewardship.