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Feb 07, 2017
Reduce Unnecessary Care
It is important to screen young children with fever who may be at risk for urinary tract infection (UTI) in order to initiate prompt treatment to assure the best outcomes. Traditionally, children who are not toilet trained have their urine obtained by inserting a catheter through the urethra into the bladder so it can be sent for culture. This procedure is uncomfortable and can be traumatic for children.
The Emergency Department (ED) at Children's Hospital of Philadelphia (CHOP) reviewed its data and found the prevalence of UTI in our patients was very low. Evidence of inflammation is required to diagnose UTI. The team developed a new method; urine was initially collected using a bag. If the urine sample from the bag did not show signs of infection, a catheterization for urine culture was not performed. After implementation, there was no increase of ED length of stay, and no children in our health system have a delay in diagnosis of UTI.
The catheterization rate decreased from 70 percent to 30 percent, and this rate continues to be sustained. No UTIs have been missed in our healthcare system.
Updated January, 2018
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