Decreasing misdiagnoses of urinary tract infections in a pediatric emergency department.

Olivia Ostrow; Michael Prodanuk; Yen Foong; Valene Singh; Laura Morrissey; Greg Harvey; Aaron Campigotto; Michelle Science

Study

Decreasing misdiagnoses of urinary tract infections in a pediatric emergency department.

August 10, 2022

Ostrow O, Prodanuk M, Foong Y, et al. Pediatrics. 2022;150(1):e2021055866.

View more articles from the same authors.

Appropriate antibiotic prescribing is a core component of antibiotic stewardship programs to reduce the risk of antibiotic-resistant microbes. This study assessed the rate of misdiagnosed pediatric urinary tract infections (UTI) and associated antibiotic use following implementation of a quality improvement intervention. Using three interventions (diagnostic algorithm, callback system, standardized discharge antibiotic prescription), misdiagnosis of UTI decreased by half, and 2,128 antibiotic days were saved.

PubMed citation

Available at

Related Resources From the Same Author(s)

Catheter-associated urinary tract infection reduction in a pediatric safety engagement network.

September 30, 2020

Improving discharge safety in a pediatric emergency department.

October 26, 2022

Economic evaluation of quality improvement interventions to prevent catheter-associated urinary tract infections in the hospital setting: a systematic review.

March 30, 2022

Reducing pediatric emergency department prescription errors.

June 22, 2022

Racial and ethnic differences in emergency department pain management of children with fractures.

April 22, 2020

The impact of racism on child and adolescent health.

July 1, 2019

Family safety reporting in medically complex children: parent, staff, and leader perspectives.

July 6, 2022

An initiative to reduce insulin-related adverse drug events in a children's hospital.

February 16, 2022

Optimizing Pediatric Patient Safety in the Emergency Care Setting.

October 19, 2022

Family safety reporting in hospitalized children with medical complexity.

July 20, 2022

Preventing home medication administration errors.

March 14, 2022

Extended work shifts and neurobehavioral performance in resident-physicians.

March 10, 2021

SAFER Care: improving caregiver comprehension of discharge instructions.

March 31, 2021

Diagnostic error in pediatrics: a narrative review.

March 23, 2022

Increasing physician reporting of diagnostic learning opportunities.

December 23, 2020

September 15, 2021

Implementation of the I-PASS handoff program in diverse clinical environments: a multicenter prospective effectiveness implementation study.

November 16, 2022

Safety II behavior in a pediatric intensive care unit.

August 1, 2018

Opioid prescribing to US children and young adults in 2019.

September 1, 2021

A system-wide hospital child maltreatment patient safety program.

September 8, 2021

A family and hospital's journey and commitment to improving diagnostic safety.

March 9, 2022

Patient and family engagement in catheter-associated urinary tract infection (CAUTI) prevention: a systematic review.

July 14, 2021

Optimizing situation awareness to reduce emergency transfers in hospitalized children.

October 20, 2021

Seroprevalence of SARS-CoV-2 among frontline health care personnel in a multistate hospital network--13 academic medical centers, April-June 2020.

September 23, 2020

Evaluation of feedback modalities and preferences regarding feedback on decision-making in a pediatric emergency department.

July 6, 2022

A customized triggers program: a children's hospital's experience in improving trigger usability.

February 8, 2023

Improving hospital infant safe sleep compliance by using safety prevention bundle methodology.

February 2, 2022

Discrepancy between emergency department admission diagnosis and hospital discharge diagnosis and its impact on length of stay, up-triage to the intensive care unit, and mortality.

February 16, 2022

Rate of sepsis hospitalizations after misdiagnosis in adult emergency department patients: a look-forward analysis with administrative claims data using Symptom-Disease Pair Analysis of Diagnostic Error methodology in an integrated health system.

May 12, 2021

Race, postoperative complications, and death in apparently healthy children.

August 12, 2020

Racial differences in antibiotic prescribing by primary care pediatricians.

March 20, 2013

Coronavirus disease 2019 (COVID-19) pandemic, central-line-associated bloodstream infection (CLABSI), and catheter-associated urinary tract infection (CAUTI): the urgent need to refocus on hardwiring prevention efforts.

February 7, 2022

Psychological safety during the test of new work processes in an emergency department.

April 6, 2022

Racism as a Root Cause approach: a new framework.

January 1, 2021

Quality and safety in hospital pediatrics during COVID-19: a national qualitative study.

January 12, 2022

Automated dispensing cabinet overrides-an evaluation of necessity in a pediatric emergency department.

May 25, 2022

The effects of rudeness, experience, and perspective-taking on challenging premature closure after pediatric ICU physicians receive hand-off with the wrong diagnosis: a randomized controlled simulation trial.

December 9, 2020

Impact of CancelRx on discontinuation of controlled substance prescriptions: an interrupted time series analysis.

March 23, 2022

Improving diagnostic performance through feedback: the Diagnosis Learning Cycle.

September 1, 2021

Prevalence of undiagnosed diabetes identified by a novel electronic medical record diabetes screening program in an urban emergency department in the US.

February 22, 2023

Examining the effect of quality improvement initiatives on decreasing racial disparities in maternal morbidity.

May 4, 2022

Deficiencies in provider-reported interpreter use in a clinical trial comparing telephonic and video interpretation in a pediatric emergency department.

October 14, 2020

Antibiotic prescribing errors in patients discharged from the pediatric emergency department.

March 30, 2022

The effect of implementing bar-code medication administration in an emergency department on medication administration errors and nursing satisfaction.

October 21, 2020

Use of patient complaints to identify diagnosis-related safety concerns: a mixed-method evaluation.

March 3, 2021

Reliability and usability of a 7-minute chart review tool to identify pediatric prehospital adverse safety events.

August 1, 2018

Improving the approach to defining, classifying, reporting and monitoring adverse events in seriously ill older adults: recommendations from a multi-stakeholder convening.

June 15, 2022

Identifying trigger concepts to screen emergency department visits for diagnostic errors.

December 16, 2020

What can we learn from in-depth analysis of human errors resulting in diagnostic errors in the emergency department: an analysis of serious adverse event reports.

May 18, 2022

Usability of a human factors-based clinical decision support in the emergency department: lessons learned for design and implementation.

May 11, 2022

Provider bias in prescribing opioid analgesics: a study of electronic medical records at a hospital emergency department.

September 8, 2021

A pause in pediatrics: implementation of a pediatric diagnostic time-out.

September 14, 2022

Diagnostic errors in pediatric critical care: a systematic review.

April 28, 2021

Addressing adultification of black pediatric patients in the emergency department: a framework to decrease disparities.

September 7, 2022

Artificial intelligence versus clinicians: systematic review of design, reporting standards, and claims of deep learning studies.

May 13, 2020

Clinically significant medication errors in surgical units detected by clinical pharmacist: a real-life study.

November 10, 2021

Incidence and characteristics of errors detected by a short team briefing in pediatric anesthesia.

August 24, 2022

Accuracy of emergency department clinical findings for diagnosis of coronavirus disease 2019.

July 29, 2020

Prolonged diagnostic intervals as marker of missed diagnostic opportunities in bladder and kidney cancer patients with alarm features: a longitudinal linked data study.

February 17, 2021

Clinician distress and inappropriate antibiotic prescribing for acute respiratory tract infections: a retrospective cohort study.

May 11, 2022

Why test results are still getting "lost" to follow-up: a qualitative study of implementation gaps.

May 12, 2021

Impact of pharmacist interventions provided in the emergency department on quality use of medicines: a systematic review and meta-analysis.

March 8, 2023

Implementing universal suicide risk screening in a pediatric hospital.

August 18, 2021

Strength of improvement recommendations from injurious fall investigations: a retrospective multi-incident analysis.

April 13, 2022

Changes in weekend and weekday care quality of emergency medical admissions to 20 hospitals in England during implementation of the 7-day services national health policy.

November 25, 2020

Identifying safe care processes when GPs work in or alongside emergency departments: a realist evaluation.

December 15, 2021

Using participatory design to engage physicians in the development of a provider-level performance dashboard and feedback system.

February 2, 2022

"Good catch, Kiddo"--enhancing patient safety in the pediatric emergency department through simulation.

December 9, 2020

Medical crisis checklists in the emergency department: a simulation-based multi-institutional randomised controlled trial.

March 17, 2021

Analysis of consistency in emergency department physician variation in propensity for admission across patient sociodemographic groups.

October 13, 2021

Handoffs: transitions of care for children in the emergency department.

January 25, 2017

Organisational crisis resource management: leading an academic department of emergency medicine through the COVID-19 pandemic.

October 7, 2020

Reducing diagnostic errors in the emergency department at the time of patient treatment.

March 29, 2023

The impact of coronavirus disease 2019 (COVID-19) on healthcare-associated infections in 2020: a summary of data reported to the National Healthcare Safety Network.

September 22, 2021

Problems in care and avoidability of death after discharge from intensive care: a multi-centre retrospective case record review study.

February 10, 2021

Strengths and weaknesses in the diagnostic process of endometriosis from the patients' perspective: a focus group study.

September 15, 2021

Addressing mistreatment of providers by patients and family members as a patient safety event.

February 16, 2022

Impact of teamwork and communication training interventions on safety culture and patient safety in emergency departments: a systematic review.

January 26, 2022

Maximum emergency department overcrowding is correlated with occurrence of unexpected cardiac arrest.

July 8, 2020

Emergency departments are higher-risk locations for wrong blood in tube errors.

September 29, 2021

The effectiveness of interruptive prescribing alerts in ambulatory CPOE to change prescriber behaviour and improve safety.

May 5, 2021

Prospective validation of classification of intraoperative adverse events (ClassIntra): international, multicentre cohort study.

October 7, 2020

Worldwide incidence of surgical site infections in general surgical patients: a systematic review and meta-analysis of 488,594 patients.

December 8, 2021

Incidence of prescription errors in patients discharged from the emergency department.

September 22, 2021

Analysis of risk factors for patient safety events occurring in the emergency department.

October 7, 2020

We asked the experts: the WHO Surgical Safety Checklist and the COVID-19 pandemic: recommendations for content and implementation adaptations.

March 17, 2021

Advancing diagnostic safety research: results of a systematic research priority setting exercise.

February 24, 2021

Antecedent treat-and-release diagnoses prior to sepsis hospitalization among adult emergency department patients: a look-back analysis employing insurance claims data using Symptom-Disease Pair Analysis of Diagnostic Error (SPADE) methodology.

December 8, 2021

Performance of a trigger tool for detecting drug-related hospital admissions in older people: analysis from the OPERAM trial.

February 16, 2022

SECUre: a multicentre survey of the safety of emergency care in UK emergency departments.

November 24, 2021

What contributes to diagnostic error or delay? A qualitative exploration across diverse acute care settings in the United States.

May 26, 2021

Optimizing Therapy to Prevent Avoidable Hospital Admissions in Multimorbid Older Adults (OPERAM): cluster randomised controlled trial.

August 18, 2021

Emergency physician perceptions of electronic health record usability and safety.

May 12, 2021

Racial and ethnic differences in emergency department diagnostic imaging at US Children's Hospitals, 2016-2019.

January 4, 2021

Missed acute myocardial infarction in the emergency department-standardizing measurement of misdiagnosis-related harms using the SPADE method.

August 19, 2020

From principles to practice: embedding clinical reasoning as a longitudinal curriculum theme in a medical school programme.

June 15, 2022

Experience of hospital-initiated medication changes in older people with multimorbidity: a multicentre mixed-methods study embedded in the OPtimising thERapy to prevent Avoidable hospital admissions in Multimorbid older people (OPERAM) trial.

December 7, 2022

June 8, 2022

Alert burden in pediatric hospitals: a cross-sectional analysis of six academic pediatric health systems using novel metrics.

November 3, 2021

Training in safe opioid prescribing and treatment of opioid use disorder in internal medicine residencies: a national survey of program directors.

October 12, 2022

Related Resources

WebM&M Cases

Do Not Miss Sepsis Needles in Viral Haystacks!

March 27, 2024

Medication errors in pediatric emergency departments: a systematic review and recommendations for enhancing medication safety.

March 20, 2024

Telemedicine vs telephone consultations and medication prescribing errors among referring physicians: a cluster randomized crossover trial.

March 13, 2024

Assessing the safety of a new clinical decision support system for a national helpline.

February 14, 2024

Characteristics and patient impact of boarding in the pediatric emergency department, 2018-2022.

January 24, 2024

WebM&M Cases

Weight and Height Juxtaposition in the Electronic Medical Record Causing an Accidental Medication Overdose

October 31, 2023

Clinical pathway adherence and missed diagnostic opportunities among children with musculoskeletal infections.

September 6, 2023

In situ simulation as a quality improvement tool to identify and mitigate latent safety threats for emergency department SARS-CoV-2 airway management: a multi-institutional initiative.

June 28, 2023

Developing electronic clinical quality measures to assess the cancer diagnostic process.

June 21, 2023

Patient Safety Innovations

Remote Response Team and Customized Alert Settings Help Improve Management of Sepsis

May 31, 2023

Perspectives on Safety

Annual Perspective

Technology as a Tool for Improving Patient Safety

March 29, 2023

Crisis in the Lakeshore Hospital ER.

March 8, 2023

Determination of unnecessary blood transfusion by comprehensive 15-hospital record review.

January 25, 2023

Jake Tapper shares harrowing story of daughter's near-fatal misdiagnosis.

December 15, 2022

Electronic diagnostic support in emergency physician triage: qualitative study with thematic analysis of interviews.

November 16, 2022

Implementation and facilitation of post-resuscitation debriefing: a comparative crossover study of two post-resuscitation debriefing frameworks.

November 2, 2022

Tipping the balance: a systematic review and meta-ethnography to unfold the complexity of surgical antimicrobial prescribing behavior in hospital settings.

August 10, 2022

How safe are paediatric emergency departments? A national prospective cohort study.

August 3, 2022

Reducing pediatric emergency department prescription errors.

June 22, 2022

Automated dispensing cabinet overrides-an evaluation of necessity in a pediatric emergency department.

May 25, 2022

Clinician distress and inappropriate antibiotic prescribing for acute respiratory tract infections: a retrospective cohort study.

May 11, 2022

Adherence to national guidelines for timeliness of test results communication to patients in the Veterans Affairs health care system.

May 4, 2022

Medication safety in the emergency department: a study of serious medication errors reported by 101 hospitals from 2011 to 2020.

March 30, 2022

Antibiotic prescribing errors in patients discharged from the pediatric emergency department.

March 30, 2022

Implementation of an antibiotic stewardship program in long-term care facilities across the US.

March 9, 2022

Technology-based closed-loop tracking for improving communication and follow-up of pathology results.

February 2, 2022

Reducing surgical specimen errors through multidisciplinary quality improvement.

June 16, 2021

An estimate of missed pediatric sepsis in the emergency department.

June 2, 2021

What are the implications for patient safety and experience of a major healthcare IT breakdown? A qualitative study.

May 26, 2021

Patient Safety Innovations

Algorithm-Based Decision Support System Guides Trauma Staff During Initial Treatment, Leading to Fewer Medical Errors

March 3, 2021

See More About The Topic

Emergency Departments

Pathology and Laboratory Medicine

Pediatric Emergency Medicine

Infectious Diseases

Ordering/Prescribing Errors

Decreasing misdiagnoses of urinary tract infections in a pediatric emergency department.

Remote Response Team and Customized Alert Settings Help Improve Management of Sepsis

Algorithm-Based Decision Support System Guides Trauma Staff During Initial Treatment, Leading to Fewer Medical Errors

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Decreasing misdiagnoses of urinary tract infections in a pediatric emergency department.

Remote Response Team and Customized Alert Settings Help Improve Management of Sepsis

Algorithm-Based Decision Support System Guides Trauma Staff During Initial Treatment, Leading to Fewer Medical Errors

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Submit Your Innovations

Continue as a Guest

Continue Logged In

Submit Your Innovations

Continue as a Guest

Continue logged in

New Users to the PSNet site