De-implementing PreOp Urine Testing
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Interventional Project Site Visit.
- Who it may be relevant to
- Registry conditions: Urinary Tract Infection, Asymptomatic Bacteriuria. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- United States
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Unsure about the terms? Read our patient guide →
Official title
De-implementation of Unnecessary Pre-Operative Urine Testing
Overview
This is a randomized study to evaluate the effectiveness and implementation of an intervention to decrease unnecessary urine testing for surgical patients (Less is More for Surgical Urine Testing) across six geographically diverse Veterans Affairs Medical Centers. The intervention will unfold over two years, in three phases: control, intervention, and sustainability.
Detailed description
The purpose of this study is to implement our surgery-tailored evidence based 'Kicking CAUTI' intervention package in diverse surgical settings across the Veterans Affairs Medical Centers (VAMCs), and assess its effectiveness at de-implementing low-value perioperative urine testing and related inappropriate antibiotic prescribing. In this hybrid type 2 effectiveness-implementation study, the investigators will conduct a stepped wedge cluster randomized trial to evaluate the effectiveness, implementation, and cost of the tailored intervention at up to six VAMCs.
Interventions
- Behavioral Interventional Project Site Visit
Activities occurring during the 12-month intervention phase * 1:1 meetings introducing the project * Site Visit (once during intervention period) * Interactive teaching cases and didactic sessions * Distribution of algorithm as pocket cards * Access to project materials on SharePoint * Feedback reports on clinical outcomes * Evidence-based order set templates * Learning collaborative webinars * Individualized coaching
Primary outcome measures
- Number of Urine Testing Performed [Time frame: up to 48 months]
Secondary outcome measures (2)
- Number of Days of Therapy [Time frame: up to 48 months]
- Budget Impact Analysis [Time frame: up to 48 months]
Eligibility criteria
Inclusion criteria
- Medical Centers part of the Veterans Affairs Health Administration (VAMCs)
- VAMCs that perform standard, intermediate, or advanced surgical procedures
- VAMCs in which perioperative urine testing is performed among greater than 10% of their non-urologic, non-transplant surgery procedures
Exclusion criteria
- VAMCs that only perform ambulatory surgery (outpatient/day surgery only)
- VAMCs that do not perform urine testing among at least 10% of their non-urologic, non-transplant surgery procedures
- VAMCs that already have implemented interventions to reduce perioperative urine testing
- VAMCs' units performing genitourinary or transplant surgeries
- Database of patients with a diagnosis of urinary tract infection within 30 days before surgery
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Sequential
- Masking
- Open label
- Primary purpose
- Health services research
Study locations
United States · 1 center
- William S. Middleton Memorial Veterans Hospital, Madison, WI — Madison
Identifiers
NCT: NCT07411209 · HSR5-024-24W · I01RD000425-01A2