{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T01:20:06Z","timestamp":1791508806163,"version":"4.3.4"},"reference-count":43,"publisher":"Wiley","issue":"S2","license":[{"start":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T00:00:00Z","timestamp":1730851200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100005440","name":"Center for Scientific Review","doi-asserted-by":"publisher","award":["NIH NCMRR R03 1R03HD107667"],"award-info":[{"award-number":["NIH NCMRR R03 1R03HD107667"]}],"id":[{"id":"10.13039\/100005440","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007217","name":"Health Services Research and Development","doi-asserted-by":"publisher","award":["IK2 HX002484"],"award-info":[{"award-number":["IK2 HX002484"]}],"id":[{"id":"10.13039\/100007217","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;amp;R"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Catheter\u2010associated 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\u2010making challenge when determining whether antibiotic treatment is appropriate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To conduct preimplementation SCI\u2010focused adaptations to the evidence\u2010based practice (EBP) \u201cKicking CAUTI\u201d\u2014to develop a guide for SCI providers surrounding testing and treatment of CAUTI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Four 1\u2010hour 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\u2010based Implementation Strategies (FRAME\u2010IS) was used to plan and report adaptations in this work and the integrated Promoting Action on Research Implementation in Health Services (i\u2010PARIHS) framework to guide adaptation of the EBP for the SCI population. Content and thematic analysis guided our process.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The clinical algorithm was simplified, a urinary symptom assessment added, and provider\u2010 and patient\u2010facing educational materials were developed to support implementation efforts to create the Test Smart Treat Smart Intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Traditional 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pmrj.13279","type":"journal-article","created":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T07:29:40Z","timestamp":1730878180000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Test Smart, Treat Smart\u2010using clinician feedback to adapt a catheter\u2010associated urinary tract infection intervention for spinal cord injury"],"prefix":"10.1002","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5840-0574","authenticated-orcid":false,"given":"Hilary","family":"Touchett","sequence":"first","affiliation":[{"name":"Center for Innovations in Quality, Effectiveness and Safety (IQuESt) Michael E. DeBakey VA Medical Center  Houston Texas USA"},{"name":"Section of Health Services Research, Department of Medicine Baylor College of Medicine  Houston Texas USA"},{"name":"South Central Mental Illness Research, Education, Clinical Center, a Virtual Center  North Little Rock Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelley","family":"Arredondo","sequence":"additional","affiliation":[{"name":"Center for Innovations in Quality, Effectiveness and Safety (IQuESt) Michael E. DeBakey VA Medical Center  Houston Texas USA"},{"name":"Section of Health Services Research, Department of Medicine Baylor College of Medicine  Houston Texas USA"},{"name":"South Central Mental Illness Research, Education, Clinical Center, a Virtual Center  North Little Rock Arkansas USA"},{"name":"VHA Office of Rural Health's Veterans Resource Center in White River Junction  White River Junction Vermont USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Casey","family":"Hines\u2010Munson","sequence":"additional","affiliation":[{"name":"Center for Innovations in Quality, Effectiveness and Safety (IQuESt) Michael E. DeBakey VA Medical Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivy","family":"Poon","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice Texas Southern University  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally Ann","family":"Holmes","sequence":"additional","affiliation":[{"name":"H. Ben Taub Department of Physical Medicine and Rehabilitation Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara W.","family":"Trautner","sequence":"additional","affiliation":[{"name":"Center for Innovations in Quality, Effectiveness and Safety (IQuESt) Michael E. 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