Conception and development of Urinary Tract Infection indicators to advance the quality of spinal cord injury rehabilitation: SCI-High Project

The Journal of Spinal Cord Medicine, 2019 · DOI: 10.1080/10790268.2019.1647928 · Published: January 1, 2019

Spinal Cord Injury Immunology Healthcare

Simple Explanation

Urinary tract infections (UTI) are a frequent complication after spinal cord injury, impacting health, quality of life, and rehabilitation services. A team of experts developed UTI indicators using evidence synthesis and consensus methods, focusing on key factors influencing UTI. The indicators developed include a structure indicator (follow-up with a healthcare professional), a process indicator (UTI diagnostic checklist), and an outcome indicator (appropriate antibiotic prescription).

Study Duration

Not specified

Participants

Experts in Urohealth and/or UTI recognition and management and the SCI-High Project Team

Evidence Level

Not specified

Key Findings

1
A structure indicator was defined as the proportion of patients able to follow-up regarding urine culture results within 48-72 hours of collection.
2
The working group adopted a single checklist for UTI diagnosis.
3
The outcome indicator is the proportion of SCI/D rehabilitation inpatients with inappropriate antibiotic prescription.

Research Summary

The study aimed to develop quality indicators for urinary tract infection (UTI) management in spinal cord injury (SCI/D) rehabilitation to reduce inappropriate antibiotic use. A combination of evidence synthesis and consensus methods was used to develop structure, process, and outcome indicators. The developed indicators include a structure indicator focusing on healthcare professional follow-up, a process indicator using a UTI diagnostic checklist, and an outcome indicator measuring inappropriate antibiotic prescriptions.

Practical Implications

Reduce Inappropriate Antibiotic Use

The quality indicators aim to decrease the prescription of antibiotics when they are not necessary, helping to combat antibiotic resistance.

Improve UTI Diagnosis

Using a standardized checklist can lead to more accurate and consistent diagnosis of UTIs in SCI/D patients.

Enhance Access to Care

The structure indicator focuses on ensuring patients have timely access to healthcare professionals for follow-up and treatment.

Study Limitations

1
The UTI definition does not specifically address individuals with indwelling catheters.
2
There is no specified number of colony count for UTI in the checklist.
3
The checklist requires a formal knowledge translation plan for community care providers.

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