• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • 2MM Podcast
  • Write for us
  • Contact Us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home Genetics

Quality improvement methods increase adherence to pediatric UTI guidelines

byAndrew Bishara
August 19, 2013
in Genetics, Infectious Disease, Pediatrics
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

Image: PD

1. Quality improvement (QI) methods were associated with increased adherence to American Academy of Pediatrics (AAP) guidelines for imaging in children 2-24 months of age with first urinary tract infection (UTI). 

2. Though improvements were noted in both inpatient and emergency department (ED) settings, quicker and larger changes were noted in the inpatient setting.

Evidence Rating Level: 1 (Excellent) 

Study Rundown: In 2011, the AAP published new guidelines for imaging after a first UTI in children 2-24 months of age. UTIs in children can sometimes be secondary to functional or anatomic abnormalities of the genitourinary tract, with early diagnosis and correction helping to prevent further complications. Renal and bladder ultrasonography (RBUS) and voiding cystourethrogram (VCUG) are two common modalities used to diagnose anomalies. Whereas RBUS is non-invasive, VCUG is a more expensive and invasive procedure involving radiation exposure. The 2011 AAP guidelines suggest RBUS after first UTI in children 2-24 months of age followed by VCUG only if RBUS is abnormal.

This QI study, conducted at a large academic center, aimed to reduce the percentage of guideline-eligible children undergoing VCUG after normal RBUS in both inpatient and ED settings. QI methods included physician and patient education along with updated electronic medical record (EMR) order sets. Additionally, a surveillance system contacted residents of eligible patients with reminders of the guideline. Sustained improvements were noted in both settings, with a higher success rate in the inpatient setting. This study suggests that rapid implementation of national guidelines is possible through QI methods, though this specific intervention is best tailored to academic settings with an EMR.

RELATED REPORTS

Abridge drafts pediatric notes so physicians stay with the kids, not the keyboard

Evaluating scar outcomes in pediatric burn patients following skin grafting 

Trimethoprim-sulfamethoxazole during pregnancy does not reduce risk of prematurity

Click to read the study published today in Pediatrics

Relevant Reading: The New American Academy of Pediatrics Urinary Tract Infection Guideline

Study Author, Dr. Karen E. Jerardi, MD MEd, talks to 2 Minute Medicine: Division of Hospital Medicine, Cincinnati Children’s Hospital Medical Center.

“We were able to rapidly implement the American Academy of Pediatrics guideline for management for first urinary tract infection (UTI) using quality improvement methods. Practice change occurred in both the inpatient and outpatient settings; however, guideline adoption occurred with a greater magnitude in the inpatient setting. Interventions using the electronic medical record and ordering system were most impactful yet were only available for inpatient providers. Recognition of the process of outpatient management of UTI, specifically related to the timing of image ordering and completion, suggests there are opportunities for higher reliability interventions that more effectively fit into the workflow of the outpatient setting.

Imaging completion rates and results were also tracked. While fewer patients underwent voiding cystourethrograms, there were no significant differences in the percentage of patients completing renal ultrasounds or in overall rates of vesicoureteral reflux identification.”

In-Depth [Quality improvement]: Before implementation of this QI project, baseline rates of children undergoing VCUG despite normal RBUS after first UTI were 92% and 100% in the inpatient and ED settings, respectively. In response to new AAP guidelines, this project aimed to reduce the percentage of children with first UTI undergoing VCUG after normal RBUS to 5% in both settings within 120 days. QI methods include physician and patient education on the new guidelines, updated EMR order sets, and a surveillance system that notified residents of eligible patients. Pre- and post-intervention data was obtained through retrospective chart reviews. Inclusion criteria comprised of children aged 2-24 months, with an International Classification of Diseases, Ninth Revision (ICD-9) code of UTI or pyelonephritis. All included patients did not have a history of prior UTI. In one month, improvement from 92% to 0% was noted in inpatient settings. Improvement in the ED occurred from 100% to 40% over 4 months. Importantly, no significant changes in incidence of obtained RBUS or diagnosed anomalies were noted from pre- to post-intervention phases.

By Neha Joshi and Leah H. Carr

More from this author: Inhaled nitric oxide in premature infants shows no benefits, Intrapartum maternal asthma linked to increased disease in children, Racial differences noted in autism care, Short term zinc prophylaxis decreases infant diarrhea mortality, Childhood ADHD significantly associated with adult obesity

 © 2013 2minutemedicine.com. All rights reserved. No works may be reproduced without expressed written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors, editors, staff or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT.  

Tags: anatomicpediatricsquality improvementrenal ultrasoundUTIvoiding cystourethrogram (VCUG)
Previous Post

Difficulty diagnosing autism spectrum disorders in Latino children

Next Post

Healthy diet delays development, progression of chronic kidney disease in diabetics

RelatedReports

Baby-led weaning not linked to increased choking
AI Roundup

Abridge drafts pediatric notes so physicians stay with the kids, not the keyboard

July 7, 2025
Pediatrics

Evaluating scar outcomes in pediatric burn patients following skin grafting 

June 26, 2025
Implementation of pneumococcal vaccine programs linked to decreased antibiotic prescription
Infectious Disease

Trimethoprim-sulfamethoxazole during pregnancy does not reduce risk of prematurity

June 9, 2025
Weekly Rewinds

2 Minute Medicine Rewind May 19th, 2025

May 19, 2025
Next Post
Urinary mRNA profiling accurately diagnoses rejection in kidney allografts

Healthy diet delays development, progression of chronic kidney disease in diabetics

Combination therapy with tofacitinib improves response in rheumatoid arthritis

Combination therapy with tofacitinib improves response in rheumatoid arthritis

Home-based intervention reduces depressive symptoms in older African Americans

Home-based intervention reduces depressive symptoms in older African Americans

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • 2 Minute Medicine Rewind July 14, 2025
  • New obesity framework may reclassify over half of overweight individuals as people with obesity
  • Digital health apps may have limited role in reduction of migraine symptoms
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
No Result
View All Result

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.