Study looks at unnecessary UTI testing


Study looks at unnecessary UTI testing in older people at Capital & Coast

Medical student Adam Sangster recently undertook a study into nurses’ knowledge of urinary tract infection (UTI) testing guidelines, their attitudes towards UTI testing and treatment, and their testing practice.

Testing the urine in patients with no symptoms of urinary infection can lead to unnecessary treatment with antibiotics. This can in turn lead to antimicrobial resistance, antibiotic-associated colitis or other drug-specific side effects.

Adam was a summer student in the Department of Primary Health Care and General Practice, University of Otago Wellington. His work was sponsored by the Council of Medical Colleges and took place under the umbrella of the Choosing Wisely campaign, in the Capital & Coast DHB.

Adam surveyed over 70 nurses working in long-term care facilities in the Wellington region and at Kenepuru Hospital in Porirua. The study took place in December 2017.

He found there was near universal agreement by nurses that urine tests cannot cause harm. Nurses were evenly divided on whether it was safer to request a urine test for a patient, even if there was no current sign of infection, rather than potentially miss a UTI.

He says a key take-away message from the study is that the appeal of intervention is very strong.

“When you are talking to someone and they are in a lot of discomfort, it’s really hard not to do everything you can. It’s very counter intuitive.”

As the result of these findings, Adam recommends consideration of providing further education on the specific guidelines for UTI diagnosis, the potential harm caused by urine testing and how high asymptomatic bacteriuria rates in older people make positive dipstick results inconclusive.