Changing the culture of urine culturing: Utilizing Agile Implementation to improve diagnostic stewardship in the ICU.

• Agile implementation improves urine culture diagnostic stewardship in critical care. • Agile implementation engages key stakeholder and preserves provider autonomy. • Utilizing a urine culture algorithm results in significant reduction in catheter-associated urinary tract infection. • Urine culture stewardship does not result in patient harm or missed catheter-associated urinary tract infection diagnoses. Over diagnosis of catheter-associated urinary tract infection (CAUTI) contributes to unnecessary and excessive antibiotic use, selection for resistant organisms, increased risk for Clostridiodes difficile infections, as well as a false elevation in CAUTI rates. Utilizing agile implementation to implement a urine culture algorithm achieved statistically significant reduction in CAUTI rates in a critical care unit resulting in sustainment and spread throughout the system. [ABSTRACT FROM AUTHOR]