Reducing physician voiding cystourethrogram ordering in children with first febrile urinary tract infection: evaluation of a purposefully sequenced educational intervention

Background: Physicians often fail to implement clinical practice guidelines. Our aim was to evaluate whether a purposefully sequenced, multifaceted educational intervention would increase physician adherence to a guideline for voiding cystourethrogram (VCUG) use following first urinary tract infecti...

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Autores principales:	Anke Banks, Susan Samuel, David Johnson, Kent Hecker, Kevin McLaughlin
Formato:	article
Lenguaje:	EN
Publicado:	Canadian Medical Education Journal 2018
Materias:	clinical practice guideline knowledge translation PRECEDE stages of change urinary tract infection clinical pathway Education (General) L7-991 Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/0c1b87db031240189113831da2aebd69
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spelling	oai:doaj.org-article:0c1b87db031240189113831da2aebd692021-12-01T22:44:16ZReducing physician voiding cystourethrogram ordering in children with first febrile urinary tract infection: evaluation of a purposefully sequenced educational intervention10.36834/cmej.429431923-1202https://doaj.org/article/0c1b87db031240189113831da2aebd692018-11-01T00:00:00Zhttps://journalhosting.ucalgary.ca/index.php/cmej/article/view/42943https://doaj.org/toc/1923-1202Background: Physicians often fail to implement clinical practice guidelines. Our aim was to evaluate whether a purposefully sequenced, multifaceted educational intervention would increase physician adherence to a guideline for voiding cystourethrogram (VCUG) use following first urinary tract infection (UTI) in young children. Methods: Using a single centre, pretest-posttest design, we compared the proportion of guideline adherent VCUG orders and the VCUG ordering rate before and after three educational interventions (interactive lecture, clinical pathway, faxed reminder) selected and sequenced according to the PRECEDE (Predisposing, Reinforcing and Enabling Constructs in Educational Diagnosis and Evaluation) health promotion model. Results: One hundred and nine physicians ordered 219 VCUGs for 219 children. Following the interventions, there was an increase in the monthly proportion of adherent VCUGs ordered by pediatricians (analysis of variance (ANOVA) F(2,29) = 3.38, p = .048) and non-pediatricians (ANOVA F(2,28) = 14.71, p < .001). Also, pediatricians decreased their monthly VCUG ordering rate (linear trend incidence rate ratio 0.74, 95% confidence interval (CI) [0.54, 0.99]). Pediatricians were more likely to adhere with the guideline than were non-pediatricians (odds ratio 2.91, 95% CI [1.5, 5.5]). Conclusion: Exposure to purposefully sequenced educational interventions based on the PRECEDE model was associated with increased adherence to guideline recommendations. Anke BanksSusan SamuelDavid JohnsonKent HeckerKevin McLaughlinCanadian Medical Education Journalarticleclinical practice guidelineknowledge translationPRECEDEstages of changeurinary tract infectionclinical pathwayEducation (General)L7-991Medicine (General)R5-920ENCanadian Medical Education Journal, Vol 9, Iss 4 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	clinical practice guideline knowledge translation PRECEDE stages of change urinary tract infection clinical pathway Education (General) L7-991 Medicine (General) R5-920
spellingShingle	clinical practice guideline knowledge translation PRECEDE stages of change urinary tract infection clinical pathway Education (General) L7-991 Medicine (General) R5-920 Anke Banks Susan Samuel David Johnson Kent Hecker Kevin McLaughlin Reducing physician voiding cystourethrogram ordering in children with first febrile urinary tract infection: evaluation of a purposefully sequenced educational intervention
description	Background: Physicians often fail to implement clinical practice guidelines. Our aim was to evaluate whether a purposefully sequenced, multifaceted educational intervention would increase physician adherence to a guideline for voiding cystourethrogram (VCUG) use following first urinary tract infection (UTI) in young children. Methods: Using a single centre, pretest-posttest design, we compared the proportion of guideline adherent VCUG orders and the VCUG ordering rate before and after three educational interventions (interactive lecture, clinical pathway, faxed reminder) selected and sequenced according to the PRECEDE (Predisposing, Reinforcing and Enabling Constructs in Educational Diagnosis and Evaluation) health promotion model. Results: One hundred and nine physicians ordered 219 VCUGs for 219 children. Following the interventions, there was an increase in the monthly proportion of adherent VCUGs ordered by pediatricians (analysis of variance (ANOVA) F(2,29) = 3.38, p = .048) and non-pediatricians (ANOVA F(2,28) = 14.71, p < .001). Also, pediatricians decreased their monthly VCUG ordering rate (linear trend incidence rate ratio 0.74, 95% confidence interval (CI) [0.54, 0.99]). Pediatricians were more likely to adhere with the guideline than were non-pediatricians (odds ratio 2.91, 95% CI [1.5, 5.5]). Conclusion: Exposure to purposefully sequenced educational interventions based on the PRECEDE model was associated with increased adherence to guideline recommendations.
format	article
author	Anke Banks Susan Samuel David Johnson Kent Hecker Kevin McLaughlin
author_facet	Anke Banks Susan Samuel David Johnson Kent Hecker Kevin McLaughlin
author_sort	Anke Banks
title	Reducing physician voiding cystourethrogram ordering in children with first febrile urinary tract infection: evaluation of a purposefully sequenced educational intervention
title_short	Reducing physician voiding cystourethrogram ordering in children with first febrile urinary tract infection: evaluation of a purposefully sequenced educational intervention
title_full	Reducing physician voiding cystourethrogram ordering in children with first febrile urinary tract infection: evaluation of a purposefully sequenced educational intervention
title_fullStr	Reducing physician voiding cystourethrogram ordering in children with first febrile urinary tract infection: evaluation of a purposefully sequenced educational intervention
title_full_unstemmed	Reducing physician voiding cystourethrogram ordering in children with first febrile urinary tract infection: evaluation of a purposefully sequenced educational intervention
title_sort	reducing physician voiding cystourethrogram ordering in children with first febrile urinary tract infection: evaluation of a purposefully sequenced educational intervention
publisher	Canadian Medical Education Journal
publishDate	2018
url	https://doaj.org/article/0c1b87db031240189113831da2aebd69
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Reducing physician voiding cystourethrogram ordering in children with first febrile urinary tract infection: evaluation of a purposefully sequenced educational intervention

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