Spinal Cord Injury Provider Knowledge and Attitudes Toward Bacteriuria Management and Antibiotic Stewardship.
Felicia Skelton, Sarah May, Larissa Grigoryan and 4 others
PMID 32304350WHAT IT FOUND
SCI/D providers reported confidence in bacteriuria guidelines but limited recall, unclear applicability, and reasons to culture or treat outside guideline indications.
Their views, not patient outcomes, describe provider reasoning about urine testing and antibiotics.
Key findings
01Staff and resident SCI/D providers had similar guideline knowledge (median 70.6 vs 64.7).
02Staff providers reported higher self-efficacy (median 4.7 vs 4), teamwork climate (79.2 vs 72.9), and safety climate (75.0 vs 71.4) than resident physicians.
03Interview themes described treatment decisions influenced by organism type, age, or catheter strategy, even when not IDSA indications for treating asymptomatic bacteriuria.
STILL TO COME
How it was doneWhat they found
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What it does not show
Low survey response (84 of 343 invited) and only 12 interviews may introduce selection bias. The sample is limited to VHA SCI/D providers, so findings may not apply to non-VHA outpatient, emergency, inpatient, or nursing-home settings. The study reports provider knowledge, attitudes, and practice patterns, not patient outcomes or the effect of an intervention. Conflicting VHA and national guideline recommendations may shape responses. Self-reported survey and interview data cannot confirm actual prescribing or testing behavior.
Declared interests
The supplied article metadata lists NIH extramural and U.S. government non-PHS research support. No author conflict-of-interest declaration is included in the supplied text.
The easy way to misread this
Do not read these provider attitudes as evidence that changing guideline use improves SCI/D outcomes. The study reports self-reported survey and interview themes from a small, low-response VHA provider sample, not patient outcomes or a tested intervention.