Reducing unneccessary urine testing and treatment in Emergency Departments

Inappropriate use of antimicrobials for treating asymptomatic bacteriuria is a widespread issue in healthcare. Overuse of urine tests, including both urinalysis and urine cultures, as routine tests or for nonspecific symptoms, along with treating positive urine test results unnecessarily, leads to misuse of resources. This overuse can result in unnecessary antibiotic therapy with potential patient harm, including the development of bacterial resistance, adverse and allergic reactions to antibiotics, and promotion of serious infection.

Our team was recruited to explore the beliefs and processes followed by physicians and nurses regarding positive urine tests and the routine ordering of these tests. As we engaged with users we found a knowledge gap in understanding when to test the urine and that some tests were being sent “just in case”.

Together, we developed an algorithm to support a consistent testing process, aiming to reduce unnecessary urine testing and antibiotic use. Additionally, we created reference resources to aid healthcare providers in their decision-making process regarding urine testing.