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| ID | Type | Description | Link |
|---|---|---|---|
| I01RD000425-01A2 | U.S. NIH Grant/Contract | View source |
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This is a randomized study to evaluate the effectiveness and implementation of an intervention to decrease unnecessary urine testing for surgical patients (Less is More for Surgical Urine Testing) across six geographically diverse Veterans Affairs Medical Centers. The intervention will unfold over two years, in three phases: control, intervention, and sustainability.
The purpose of this study is to implement our surgery-tailored evidence based 'Kicking CAUTI' intervention package in diverse surgical settings across the Veterans Affairs Medical Centers (VAMCs), and assess its effectiveness at de-implementing low-value perioperative urine testing and related inappropriate antibiotic prescribing. In this hybrid type 2 effectiveness-implementation study, the investigators will conduct a stepped wedge cluster randomized trial to evaluate the effectiveness, implementation, and cost of the tailored intervention at up to six VAMCs.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention Site Visit | Experimental | VAMCs randomized in this arm will receive full access to our resources library, will receive invites to our monthly meetings, receive monthly feedback on clinical outcomes, access to project materials, etc. |
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| Standard of Care | No Intervention | VAMCs randomized to the standard arm will proceed with normal standard of care |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Interventional Project Site Visit | Behavioral | Activities occurring during the 12-month intervention phase
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| Measure | Description | Time Frame |
|---|---|---|
| Number of Urine Testing Performed | Throughout the study period, the research team will generate monthly lists of all urinalyses and urine cultures performed within 30 days before and 30 days after included procedures. The study team will chart review theses cases and determine whether the urine test was done on an asymptomatic patient or whether the test was justified based on UTI symptoms. | up to 48 months |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Days of Therapy | Days of therapy is an aggregate sum of days on which an antimicrobial agent was administered to an individual patient. The investigators will include systemic antibacterial agents administered within 30 days before and 30 days after surgery. The investigators will exclude doses given as standard preoperative prophylaxis and antimicrobial agents that are not used for urinary tract infections. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Marin L Schweizer-Looby, PhD BS | Contact | (608) 256-1901 | Marin.Schweizer-Looby@va.gov |
| Name | Affiliation | Role |
|---|---|---|
| Marin L. Schweizer-Looby, PhD BS | William S. Middleton Memorial Veterans Hospital, Madison, WI | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| William S. Middleton Memorial Veterans Hospital, Madison, WI | Madison | Wisconsin | 53705-2254 | United States |
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| ID | Term |
|---|---|
| D014552 | Urinary Tract Infections |
| ID | Term |
|---|---|
| D007239 | Infections |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
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Stepped Wedge Cluster Randomized Trial
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This study is a hybrid type 2 effectiveness/implementation study with a dual focus on clinical effectiveness and implementation outcomes using a stepped wedge cluster randomized trial among six recruited VAMCs.
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| up to 48 months |
| Budget Impact Analysis | Time spent by sites will be converted into cost by multiplying the hourly wage rate plus benefits for each type of healthcare professional involved in the intervention | up to 48 months |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |