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Optimizing practices to prevent urinary tract infection after cystoscopy and urodynamics in women: A quality improvement study.
Benseler, Anouk; Tomlinson, George; Lovatsis, Danny; Alarab, May; McDermott, Colleen D.
Afiliação
  • Benseler A; Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada.
  • Tomlinson G; Department of Medicine, University Health Network and Mount Sinai Hospital; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
  • Lovatsis D; Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada.
  • Alarab M; Division of Urogynecology, Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
  • McDermott CD; Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada.
Neurourol Urodyn ; 43(4): 883-892, 2024 Apr.
Article em En | MEDLINE | ID: mdl-38501377
ABSTRACT

OBJECTIVE:

The objective of this study was to reduce the incidence of urinary tract infection (UTI) in women undergoing outpatient cystoscopy and/or urodynamic studies (UDS) at our centre by identifying and then altering modifiable risk factors through an analysis of incidence variability among physicians.

METHODS:

This was a quality improvement study involving adult women undergoing outpatient cystoscopy and/or UDS at an academic tertiary urogynecology practice. Prophylactic practices for cystoscopy/UDS were surveyed and division and physician-specific UTI rates following cystoscopy/UDS were established. In consultation with key stakeholders, this delineated change concepts based on associations between prophylactic practices and UTI incidence, which were then implemented while monitoring counterbalance measures.

RESULTS:

Two "Plan-Do-Study-Act-Cycles" were conducted whereby 212 and 210 women were recruited, respectively. Change concepts developed and implemented were (1) to perform routine urine cultures at the time of these outpatient procedures, and (2) to withhold routine prophylactic antibiotics for outpatient cystoscopy/UDS, except in patients with signs of cystitis. There was no change in the incidence of early presenting UTI (9.0% vs. 9.2%, p = 0.680), but there were significantly fewer antibiotic-related adverse events reported (8.5% vs. 1.5%, p = 0.001). There was no significant change in the total incidence of UTI rates between cycles (7.8% vs. 5.6%, p = 0.649).

CONCLUSIONS:

No specific strategies to decrease the incidence of UTI following outpatient cystoscopy/UDS were identified, however, risk factor-specific antibiotic prophylaxis, as opposed to universal antibiotic prophylaxis, did not increase UTI incidence.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções Urinárias / Cistoscopia Limite: Adult / Female / Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções Urinárias / Cistoscopia Limite: Adult / Female / Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article