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| Source:PatientSafe |
I read with great interest the argument for a reflective rather than reflexive approach to ordering urine cultures in this Infection Control and Hospital Epidemiology letter to the editor by Mohamed Fakih et at. I agree, we need to be much more thoughtful and deliberate with the tests that we order, including urine cultures.
But, let's be straight. Provider education is necessary but far from sufficient for substantive practice change. Checklists, standardization, electronic medical record prompts and forcing functions tend to work best in this respect.
Which brings me to the next point. Our decision making should rarely be dichotomous, as beautifully explored in the book Decisive by Chip and Dan Heath. Instead of either/or we should consider this and that.
Thus, to minimize urine over testing and catheter associated urinary tract infections, educate providers and utilize test stewardship interventions modeled after the hierarchy of intervention effectiveness.
Change takes effort.
