Evidence map›Paper›PMID 39503324›Full record

ArticlePM & R : the journal of injury, function, and rehabilitation2025

Test Smart, Treat Smart-using clinician feedback to adapt a catheter-associated urinary tract infection intervention for spinal cord injury.

Hilary Touchett, Kelley Arredondo, Casey Hines-Munson, Ivy Poon, Sally Ann Holmes, Barbara W Trautner, Felicia Skelton

Abstract read
In one paragraph

Article in PM & R : the journal of injury, function, and rehabilitation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. An introduction to implementation science in rehabilitation medicine.PM & R : the journal of injury, function, and rehabilitation · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Hilary TouchettCenter for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, Texas, USA.ORCID 0000-0001-5840-0574
Kelley ArredondoCenter for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, Texas, USA.
Casey Hines-MunsonCenter for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, Texas, USA.
Ivy PoonDepartment of Pharmacy Practice, Texas Southern University, Houston, Texas, USA.
Sally Ann HolmesH. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, USA.
Barbara W TrautnerCenter for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, Texas, USA.
Felicia SkeltonCenter for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, Texas, USA.ORCID 0000-0002-6098-3454

Funding

Targeted Nano-drug-delivery-systems of Frist-in-class Drugs for CRPC: PK/PD Evaluation and Combination TherapyU54MD007605 · NIMHD · TEXAS SOUTHERN UNIVERSITY · PI Creaque C Tyler · 2020 to 2026
$22.0M
Quantifying the Cardiovascular and Immunologic Changes after Spinal Cord Injury to Aid Diagnosis of Clinically Meaningful InfectionsR03HD107667 · NICHD · BAYLOR COLLEGE OF MEDICINE · PI SKELTON, FELICIA · 2022 to 2023
$320k
Optimizing Bacteriuria Management in Veterans with Spinal Cord InjuryIK2HX002484 · VA · MICHAEL E DEBAKEY VA MEDICAL CENTER · PI SKELTON, FELICIA · 2018 to 2022
–
CSR NIH HHS NIH NCMRR R03 1R03HD107667HSRD VA IK2 HX002484NICHD NIH HHS R03 HD107667
6 · The paper itself

Abstract

backgroundCatheter-associated urinary tract infection (CAUTI) prevention is a major target for hospital quality metrics because it is linked to increased morbidity, mortality, and health care costs. Health care systems use strict protocols surrounding catheterization and maintenance, which often disregard the clinical needs of special populations (eg, spinal cord injury [SCI]). However, for populations that rely on chronic instrumentation of the bladder, asymptomatic (ie, nonpathogenic) bacterial colonization in the bladder is common but not linked to adverse outcomes. Additionally, alterations in neurologic and sensory function after SCI make it difficult for clinicians to discern asymptomatic bacteriuria from acute urinary tract infection requiring antibiotics. Institutional policies for screening urine during SCI annual exams often lead to detection of bacteriuria but create a clinical decision-making challenge when determining whether antibiotic treatment is appropriate.

objectiveTo conduct preimplementation SCI-focused adaptations to the evidence-based practice (EBP) "Kicking CAUTI"-to develop a guide for SCI providers surrounding testing and treatment of CAUTI.

methodsFour 1-hour focus groups were conducted with SCI clinicians (prescribers and nursing staff) to assess insights on needed modifications to adapt Kicking CAUTI for SCI. The Framework for Reporting Adaptations and Modifications to Evidence-based Implementation Strategies (FRAME-IS) was used to plan and report adaptations in this work and the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework to guide adaptation of the EBP for the SCI population. Content and thematic analysis guided our process.

resultsThe clinical algorithm was simplified, a urinary symptom assessment added, and provider- and patient-facing educational materials were developed to support implementation efforts to create the Test Smart Treat Smart Intervention.

conclusionsTraditional CAUTI protocols do not adequately address the needs of those with SCI and modifications are needed. Provider feedback provides valuable insights when adapting population appropriate interventions.

Indexed as

Anti-Bacterial AgentsCatheter-Related InfectionsSpinal Cord InjuriesUrinary CatheterizationUrinary Tract InfectionsFeedbackFemaleHumansMaleAnti-Bacterial Agents

Identifiers

PMID39503324
PMCPMC12990096

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.