De-implementing PreOp Urine Testing

NCT07411209 | Not Yet Recruiting

• 2 other identifiers: HSR5-024-24WI01RD000425-01A2
• Study Type: interventional
• Target: 6
• Locations: 1 country
• Sites: 1

Brief Summary

This is a randomized study to evaluate the effectiveness and implementation of an intervention to decrease unnecessary urine testing for surgical patients (Less is More for Surgical Urine Testing) across six geographically diverse Veterans Affairs Medical Centers. The intervention will unfold over two years, in three phases: control, intervention, and sustainability.

Conditions

Urinary Tract Infection; Asymptomatic Bacteriuria

Keywords

antibiotic stewardship; kicking cauti

Outcome Measures

Primary Outcomes (1)

• Number of Urine Testing Performed

  Throughout the study period, the research team will generate monthly lists of all urinalyses and urine cultures performed within 30 days before and 30 days after included procedures. The study team will chart review theses cases and determine whether the urine test was done on an asymptomatic patient or whether the test was justified based on UTI symptoms.

  up to 48 months

Secondary Outcomes (2)

• Number of Days of Therapy

  up to 48 months

• Budget Impact Analysis

  up to 48 months

Study Arms (2)

Intervention Site Visit

EXPERIMENTAL

VAMCs randomized in this arm will receive full access to our resources library, will receive invites to our monthly meetings, receive monthly feedback on clinical outcomes, access to project materials, etc.

Behavioral: Interventional Project Site Visit

Standard of Care

NO INTERVENTION

VAMCs randomized to the standard arm will proceed with normal standard of care

Interventions

Interventional Project Site Visit BEHAVIORAL

Activities occurring during the 12-month intervention phase * 1:1 meetings introducing the project * Site Visit (once during intervention period) * Interactive teaching cases and didactic sessions * Distribution of algorithm as pocket cards * Access to project materials on SharePoint * Feedback reports on clinical outcomes * Evidence-based order set templates * Learning collaborative webinars * Individualized coaching

Intervention Site Visit

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Medical Centers part of the Veterans Affairs Health Administration (VAMCs)
• VAMCs that perform standard, intermediate, or advanced surgical procedures
• VAMCs in which perioperative urine testing is performed among greater than 10% of their non-urologic, non-transplant surgery procedures

You may not qualify if:

• VAMCs that only perform ambulatory surgery (outpatient/day surgery only)
• VAMCs that do not perform urine testing among at least 10% of their non-urologic, non-transplant surgery procedures
• VAMCs that already have implemented interventions to reduce perioperative urine testing
• VAMCs' units performing genitourinary or transplant surgeries
• Database of patients with a diagnosis of urinary tract infection within 30 days before surgery

Sponsors & Collaborators

• VA Office of Research and Development: lead

Study Sites (1)

William S. Middleton Memorial Veterans Hospital, Madison, WI

Madison, Wisconsin, 53705-2254, United States

Location

MeSH Terms

Conditions

Urinary Tract Infections

Condition Hierarchy (Ancestors)

Infections; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Male Urogenital Diseases

Study Officials

• Marin L. Schweizer-Looby, PhD BS

  William S. Middleton Memorial Veterans Hospital, Madison, WI

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Marin L Schweizer-Looby, PhD BS

CONTACT

(608) 256-1901; Marin.Schweizer-Looby@va.gov

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: This study is a hybrid type 2 effectiveness/implementation study with a dual focus on clinical effectiveness and implementation outcomes using a stepped wedge cluster randomized trial among six recruited VAMCs.
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SEQUENTIAL
• Sponsor Type: FED
• Responsible Party: SPONSOR

Model Details: Stepped Wedge Cluster Randomized Trial

Study Record Dates

• First Submitted: February 3, 2026
• First Posted: February 13, 2026
• Study Start (Estimated): December 31, 2026
• Primary Completion (Estimated): December 31, 2028
• Study Completion (Estimated): December 31, 2030
• Last Updated: February 13, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)