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| Naji, M. |
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| Motta, Antonella |
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| Aletan, Dirar |
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| Mohamed, Tarek |
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| Ertürk, Emre |
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| Taccardi, Nicola |
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| Kononenko, Denys |
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| Petrov, R. H. | Madrid |
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| Alshaaer, Mazen | Brussels |
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| Bih, L. |
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| Casati, R. |
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| Muller, Hermance |
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| Kočí, Jan | Prague |
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| Šuljagić, Marija |
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| Kalteremidou, Kalliopi-Artemi | Brussels |
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| Azam, Siraj |
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| Ospanova, Alyiya |
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| Blanpain, Bart |
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| Ali, M. A. |
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| Popa, V. |
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| Rančić, M. |
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| Ollier, Nadège |
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| Azevedo, Nuno Monteiro |
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| Landes, Michael |
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| Rignanese, Gian-Marco |
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Slatter, Mandy
Royal United Hospital
in Cooperation with on an Cooperation-Score of 37%
Topics
Publications (3/3 displayed)
- 2023P12 Commissioning for Quality and Innovation (CQUIN) schemes—revisiting urinary tract infection (UTI) management. What worked? What lasted? What next?
- 2023Feasibility of retrospective chart review to assess alignment of urinary tract infection (UTI) diagnosis, testing and treatment decisions with UKHSA diagnostic guidelines in patients 65 years+ in the Emergency Department (ED)
- 2023P09 Feasibility of retrospective chart review to assess alignment of urinary tract infection diagnosis, testing and treatment decisions with UKHSA diagnostic guidance in patients 65 years+ in the emergency department
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document
Feasibility of retrospective chart review to assess alignment of urinary tract infection (UTI) diagnosis, testing and treatment decisions with UKHSA diagnostic guidelines in patients 65 years+ in the Emergency Department (ED)
Abstract
<b>Background:</b><br/>UTI in the elderly is a diagnostically challenging Emergency Department (ED) infection. UK Health Security Agency (UKHSA) diagnostic tool use is promoted in England.<br/><br/><b>Aim:</b><br/>To assess feasibility of chart review to quantify alignment with UKHSA guidelines.<br/><br/><b>Methods:</b><br/>Population: patients attending ED; ≥65 years; primary UTI diagnosis; not admitted. Clinical notes reviewed for UTI symptoms/signs and associated: (i) urine dipstick; (ii) urine sent for microscopy, culture, and sensitivity (MC&S); (iii) antibiotic treatment. Management considered aligned if: (i) documented symptoms/signs match diagnostic criteria and (ii) testing and treatment as recommended. Data collection time recorded.<br/><br/><b>Results:</b><br/>6076 ED attendances 65+, August-October 2021;116 (not admitted) with UTI related descriptor; 40treated as UTI.<br/><br/>Documented symptoms/signs aligned with lower UTI/pyelonephritis diagnostic criteria in 27/40 (67.5%); recommendation of no dipstick, urine sample (MC&S), antibiotic treatment followed in 7, 16 and 26 of 27, respectively.<br/><br/>Thirteen of 40 (32.5%) had no documented aligned UTI symptoms/signs; consequent recommendation of no dipstick, no urine sample (MC&S), no antibiotic treatment followed in 5, 7 and 4 of 13 respectively.<br/><br/>Five of 40 (12.5%) followed recommended pathway; 30/40 (75%) received recommended treatment; unnecessary tests included 27 dipsticks and 6 urine samples; urine sample recommended but not taken in 11 patients.<br/><br/>Time to collect data: 20 hrs.<br/><br/><b>Discussion:</b><br/>Alignment with UKHSA guidelines is low, possibly due to poor documentation. Testing where symptoms not aligned appeared to result in unnecessary antibiotics. Chart review is probably not feasible for larger studies. Future research could investigate if alignment is associated with patient outcomes.<br/>