Improving the appropriateness of laboratory submissions for urinalysis from general practice

Abstract

The 12% decrease in urine submissions from 16- to 64-year olds, attained with workshops, may help counter relentlessly rising test submissions. Modified forms are currently not worth pursuing. When educational workshops are used across PCTs to change practice, the change in test submission is smaller than attained in educational initiatives involving volunteers. Workshops may be more effective if they also discuss urine submissions from asymptomatic patients and are directed at high testing practices and care homes.

Impact of long-term care facility residence on the antibiotic resistance of urinary tractEscherichia coliandKlebsiella

“…22 However, clinical guidelines emphasise that only urinary samples from patients with a clinically suspected UTI, and either a risk factor for resistance or a history of UTIs should be sent for laboratory testing, and that catheter samples should not be sent. 21,32 This dataset only included positive samples. The likelihood of an elderly individual with a UTI having a urinary sample submitted might differ in LTCF residents and those living in the community, which could bias results.…”

How usual is usual care in pragmatic intervention studies in primary care? An overview of recent trials

“…40 In the majority of articles on cluster randomised trials, the information provided to control caregivers was not described. Only three papers explicitly stated that control caregivers were not aware of the exact content of the intervention; they received either an unrelated educational module, 70,71 or neutral information about the trial without an explanation of the intervention. 73 In some individually randomised and some cluster randomised trials, control caregivers were asked to complete questionnaires before or during the intervention period.…”

Do English NHS Microbiology laboratories offer adequate services for the diagnosis of UTI in children? Healthcare Quality Improvement Partnership (HQIP) Audit of Standard Operational Procedures

“…Previous work has shown a wide variation in urine specimen submission to laboratories ( McNulty et al , 2004 ) and this audit corroborates this, with a 100-fold variation in submission rate across the 83 laboratories returning data. Trends in the rates of urine submissions can be used as a measure of efforts by clinicians to improve the rate of diagnosis of UTI ( McNulty et al , 2008 ). Only one of our laboratories with data pre- and post-2007 had any significant change in urine submission, suggesting NICE guidance has had little effect on submission of urines in children under three years.…”