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Journal of Bone and Joint Infection An open-access journal of the European Bone and Joint Infection Society and the MusculoSkeletal Infection Society
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This stepwise quality improvement project sought to reduce unnecessary preoperative testing for asymptomatic bacteriuria prior to elective arthroplasty. A new guideline removing routine urine testing from preoperative assessment was successfully implemented and there was a sustained reduction in the number of unnecessary preoperative urine cultures performed. This study is useful to other centres as an example of how implementation methodology can be used to challenge outdated clinical practice.
JBJI | Articles | Volume 6, issue 3
J. Bone Joint Infect., 6, 57–62, 2020
https://doi.org/10.5194/jbji-6-57-2020
J. Bone Joint Infect., 6, 57–62, 2020
https://doi.org/10.5194/jbji-6-57-2020

Original full-length article 21 Dec 2020

Original full-length article | 21 Dec 2020

Using implementation science to develop and implement a guideline to reduce unnecessary preoperative testing for asymptomatic bacteriuria prior to elective arthroplasty

Judith S. L. Partridge et al.

Cited articles

Abrutyn, E.: Does Asymptomatic Bacteriuria Predict Mortality and Does Antimicrobial Treatment Reduce Mortality in Elderly Ambulatory Women?, Ann. Intern. Med., 120, 827–833, https://doi.org/10.7326/0003-4819-120-10-199405150-00003, 1994. 
British Orthopaedic Association: Primary total hip replacement: a guide to good practice, 3rd edn., available at: https://www.britishhipsociety.com/uploaded/Blue Book 2012 fsh nov 2012.pdf (last access: 3 May 2020), 2012. 
Braithwaite, J., Marks, D., and Taylor, N.: Harnessing implementation science to improve care quality and patient safety: a systematic review of targeted literature, Int. J. Health Care Qual. Assur., 26, 321–329, https://doi.org/10.1093/intqhc/mzu047, 2014. 
Cai, T., Koves, B., and Johansen, T.: Asymptomatic bacteriuria, to screen or not to screen – and when to treat?, Curr. Opin. Urol., 27, 107–111, 2017. 
David, T. and Vrahas, M.: Perioperative Lower Urinary Tract Infections and Deep Sepsis in Patients Undergoing Total Joint Arthroplasty, J. Am. Acad. Orthop. Surg., 8, 66–74, https://doi.org/10.5435/00124635-200001000-00007, 2000. 
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Short summary
This stepwise quality improvement project sought to reduce unnecessary preoperative testing for asymptomatic bacteriuria prior to elective arthroplasty. A new guideline removing routine urine testing from preoperative assessment was successfully implemented and there was a sustained reduction in the number of unnecessary preoperative urine cultures performed. This study is useful to other centres as an example of how implementation methodology can be used to challenge outdated clinical practice.
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