Test Smart, Treat Smart-using clinician feedback to adapt a catheter-associated urinary tract infection intervention for spinal cord injury.
Hilary Touchett, Kelley Arredondo, Casey Hines-Munson and 4 others
PMID 39503324WHAT IT FOUND
Spinal cord injury clinicians described a dilemma: routine urine cultures often reveal bacteria without symptoms, creating pressure to prescribe unnecessary antibiotics.
They asked for a decision support tool that focuses on assessing atypical symptoms like urine odor and spasms rather than treating lab results alone.
Key findings
01Clinicians reported that routine urine cultures in spinal cord injury patients often show bacteria without symptoms, creating pressure to prescribe antibiotics despite concerns about resistance.
02The adapted intervention now uses a validated questionnaire to assess atypical symptoms such as urine odor, sediment, and increased spasms, rather than relying solely on culture results.
03Implementation requires patient buy-in, as clinicians noted patients may expect antibiotics based on lab results or demand them for symptom relief, leading to non-adherence if expectations are not managed.
STILL TO COME
How it was doneWhat they found
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What it does not show
The study was conducted in a single spinal cord injury department at one hospital, limiting generalizability. Only 14 staff members participated, so the findings reflect a small group's perspectives. The intervention has not yet been tested for effectiveness in reducing antibiotic use or improving outcomes; this paper only describes the adaptation process. The applicability of the tool is limited to populations with neurogenic bladder, as it was designed specifically for insensate patients.
Declared interests
The research was supported by the National Institutes of Health and the U.S. Government, with no reported conflicts of interest from the authors.
The easy way to misread this
Do not assume this adapted program has been proven to reduce antibiotic use or improve patient outcomes. This paper only describes the development of the intervention based on clinician feedback; effectiveness has not yet been tested.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →