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NCT Number: NCT07411209

De-implementing PreOp Urine Testing

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.

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Key information

Conditions

Urinary Tract Infection Asymptomatic Bacteriuria Female Urogenital Diseases Female Urogenital Diseases and Pregnancy Complications Infections Male Urogenital Diseases Urinary Tract Infections Urogenital Diseases Urologic Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

William S. Middleton Memorial Veterans Hospital, Madison, WI

Madison, Wisconsin, 53705-2254, United States

Location contact

Julie A Keating, PhD

CONTACT

[email protected]

608-256-1901 ext. 12542

Marin L. Schweizer-Looby, PhD BS

PRINCIPAL_INVESTIGATOR

About this study

The purpose of this study is to implement our surgery-tailored evidence based 'Kicking CAUTI' intervention package in diverse surgical settings across the Veterans Affairs Medical Centers (VAMCs), and assess its effectiveness at de-implementing low-value perioperative urine testing and related inappropriate antibiotic prescribing. In this hybrid type 2 effectiveness-implementation study, the investigators will conduct a stepped wedge cluster randomized trial to evaluate the effectiveness, implementation, and cost of the tailored intervention at up to six VAMCs.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 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

Exclusion criteria

  • 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

Treatment and study plan

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

Primary outcomes

  1. Number of Urine Testing Performed

    Time frame: up to 48 months

    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.

Secondary outcomes

  1. Number of Days of Therapy

    Time frame: up to 48 months

    Days of therapy is an aggregate sum of days on which an antimicrobial agent was administered to an individual patient. The investigators will include systemic antibacterial agents administered within 30 days before and 30 days after surgery. The investigators will exclude doses given as standard preoperative prophylaxis and antimicrobial agents that are not used for urinary tract infections.

  2. Budget Impact Analysis

    Time frame: up to 48 months

    Time spent by sites will be converted into cost by multiplying the hourly wage rate plus benefits for each type of healthcare professional involved in the intervention

Study contacts

Contact information is provided by the study sponsor or research team.

Marin L Schweizer-Looby, PhD BS

CONTACT

[email protected]

(608) 256-1901

Sponsors and collaborators

Lead sponsor

VA Office of Research and Development

Fed

Registry information

Official study title

De-implementation of Unnecessary Pre-Operative Urine Testing

Important dates

Study start
2026
Primary completion
2028
Study completion
2030
First posted
Feb 13, 2026
Registry last updated
Feb 13, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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