Journal Club Summary
Methodology Score: 4/5
Usefulness Score: 4/5
Stagg A, et al. BMJ Qual Saf. 2018 Feb;27(2):140-147.
Question and Methods: This QI time-series analysis assessed the efficacy, safety and costs of a 2-step urine culture (UC) collection system.
Findings: There was a decrease in UC processing (5.9%-4.6%), positive UCs callbacks (1.8%-1.1%), and urinary antibiotic prescribing in admitted patients (20%-10%) without detrimental effects on balancing measures.
Limitations: Limitations include the lack of reported antibiotic-related adverse events, the preservative system used, and the small absolute magnitude in change of UC-processing.
Interpretation: QI work must be compared to one’s context and after reviewing our hospital’s current state and process the findings of this study are generalizable.
Epi Lesson
Quality improvement interventions are designed to improve quality of care within an institutional context and are often complex, multi-component, and tailored to the local setting. These systematic, data-guided activities are designed to bring about immediate improvements in health care delivery at particular settings. Often QI initiatives set out to implement best practices that have previously been evaluated for effectiveness.
By: Dr. Ian Stiell
