Diagnostic Stewardship
Diagnostic stewardship is a set of clinical criteria used to make a decision about ordering these.
What is UA/culture and antibiotics
I knows it's a UTI when urine smells and looks this way
What is foul smell, and cloudy appearing
This tool is used to optimize communicate with a provider when immediate attention is needed.
What is an SBAR
This is the preferred criteria for determining the need for treatment of a UTI in a SNF resident
What is Loeb criteria
Patients that have confusion or experience a fall of unknow reason and are stable should have this done
What is watchful waiting
50%-100% of these individuals are colonized with bacteria in their urine
What are nursing home residents
I know it's a UTI when these cells are seen on the UA
What are WBCs
The UTI SBAR Background includes these four items
What are presence of a catheter, on hemodialysis, medication allergies, on anticoagulation, advanced directives, incontinence
Residents without a catheter are consider to have a UTI with the presence of this single symptom
What is dysuria
Watchful waiting may include an order for this lab
What is urinalysis
About 28% of these patients are colonized with bacteria in urine
What are patients on hemodialysis
I know it's a UTI when the UA shows this positive result
What is a leukocyte esterase
The UTI SBAR Assessment should include the presence of these four symptoms in a non-catheterized patient
What is fever, dysuria, urgency, frequency, flank pain, gross hematuria, incontinence change
Residents with a catheter or who are nonverbal should have one of these four findings to meet criteria for UTI
What are fever, costovertebral angle tenderness, rigors or new onset delirium
Watchful waiting means these two measures to be done for 24-48 hours.
What is monitoring and hydration.
This test has low specificity for diagnosing a urinary tract infection
What is a urine culture
I know it's a UTI when my patient experiences this non-specific symptom
What is agitation, confusion or delirium
The UTI SBAR Recommendations rarely includes one of these two items without the other
What is labs (UA and culture) and antibiotics
This on-line tool uses Loeb criteria to help make a decision about treatment
What is the AHRQ "Minimum Criteria Tool for Antibiotics"
Using this for more than 30 days is associated with the highest rates of bacterial colonization
What is an indwelling catheter
When my patient has a fever, confusion and bacteriuria I know this must be ____
What is a urinary tract infection
A UTI SBAR Assessment that does not show local UTI symptoms should have orders for these two measures
What is hydration and monitoring.
This criteria is not recommended for assessing the need for treatment of a UTI but instead can be used for surveillance
What is McGeer's crteria