Articles | Volume 6, issue 3
https://doi.org/10.5194/jbji-6-57-2020
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, Madeleine Daly, Carolyn Hemsley, Zameer Shah, Krishanthi Sathanandan, Cathryn Mainwaring, and Jugdeep K. Dhesi

Cited articles

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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 This study is useful to other centres as an example of how implementation methodology can be used to challenge outdated clinical practice.