Reduction of Patient Harm Through Decreasing Urine Culture Contamination in an Emergency Department Using Multiple Process Improvement Interventions

BACKGROUND: From August 2018 to January 2019, the baseline urine sample contamination rate at an acute care hospital emergency department (ED) was 51%. Urine culture is associated with unnecessary antibiotic use, repeat costs, and inpatient admissions. These outcomes can lead additional cost patient healthcare system while leading poor outcomes. METHODS: Culture results were reviewed project definition of applied. Contaminated cultures further via manual electronic health record review ED notes determine documentation collection source, education prior clean catch collection, cognitive physical documented descriptions patient, name staff member who collected sample. INTERVENTION: Staff educated on appropriate midstream straight catheter techniques, verbal along picture for patients, identification patients may benefit from catheterization instead catch. RESULTS: The combined interventions resulted in a six-month decrease contaminated samples initial 51% <10%, resulting 80% decrease. CONCLUSION: sustainably decreased through multiple process improvement interventions. Secondary included reduction cultures,