Screening for Asymptomatic Bacteria in the Urine during Pregnancy

Introduction

The purpose of this CAPRE program is to provide you and your patient with critically appraised information on current knowledge about screening for Urinary Tract Infections (UTI) during Pregnancy.

Specific knowledge objectives are:

1. To understand the importance of testing pregnant women for asymptomatic bactururia.
2. To understand the management of bactururia in pregnancy to improve outcomes for both mother and child.

The CAPRE concept then includes presenting the information to the patient, providing the patient an opportunity to consider the impact of critically appraised suggestions on them, and then, on a follow-up visit, deciding with the patient what the best course of action should be.

By observing each step and then reflecting on the outcome of the exercise and providing a report detailing your observation, we hope that you will be encouraged to incorporate critically appraised information and strategies into daily practice for the benefit of your patients.

The 5 Steps to Completing this Program

Step 1. The Critical Appraisal: Review the Critically Appraised information on using ASA to prevent heart attacks and then initiate the automatic literature search on the topic. Have any new articles been published since the bibliography was created on which the review is based? If new material is found, review the newly identified material to determine if it might change what is recommended.

Step 2. Patient Selection:Identify a patient in your practice for whom the problem applies and who you think would be receptive to a new strategy. Print the Patient Information Sheet and the Physician-Patient Partnership Paper (PPPP).

Step 3. Information for Patient. Present the information to the patient, encouraging the patient to consider the recommendations, to complete the PPPP form and to return to discuss his/her conclusion with you.

Step 4. Physician-Patient Partnership. On the return visit negotiate an agreement based on finding "common ground" that is best for the individual patient. This may or may not include completing the PPPP form. Many physicians find that using a patient-centred method without recording a formal contract with the patient is adequate. Physicians who are concerned that evidence-based recommendations may not conform to practice in their community may find the written agreement helpful.

Step 5. Practice Reflection Exercise: Complete the on-line Practice Reflection Exercise with your observations and reflections on the process and consider how you might have dealt with incorporating new ideas into your practice more effectively. Submit your results. Also complete and submit the Program Evaluation. Completion of both the Practice Reflection Exercise and the Program Evaluation are required to claim credits.