Room Equipment Research Articles

A novel simple traumatic brain injury mouse model

BackgroundTraumatic brain injury, one of the leading causes of death in adults under 40 years of age in the world, is frequently caused by mechanical shock, resulting in diffuse neuronal damage and long-term cognitive dysfunction. Many existing TBI animal models revival with expensive equipment or special room are needed or the processes of operations are complex and not easy to be widely used. Therefore, a simpler TBI model needs to be designed.MethodsOur TBI model is an innovation of the modeling method through air guns shutting rubber bullets. A core facet is the application of our designed rubber bullet impact device. It could focus the hitting power to the fixed site of the brain, thus triggering a mild closed head injury. Moreover, the degree of damage can be adjusted by the times of shots.ResultsOur model induced blood-brain barrier leakage and diffused neuronal damage. Besides, it led to an increased level of Tau phosphorylation and resulted in cognitive dysfunction within several weeks post-injury.ConclusionOur TBI model is not only simple and time-saving but also can simulate mild brain injuries in clinical. It is suitable for exploring pathobiological mechanisms as well as a screening of potential therapies for TBI.

A Magic Filter Filled with Waste Plastic Shavings, Loofah, and Iron Shavings for Wastewater Treatment.

Integrated sewage treatment equipment has been widely used, but the commonly used fillers for wastewater treatment are not suitable in rural areas due to their price and performance issues. In this study, an integrated magic filter filled with waste fillers was proposed and established for wastewater treatment. The filter was composed of functional modules and an equipment room, and the fillers in each module can be taken out separately and changed arbitrarily according to the needs of specific treatment conditions. The fillers used include waste plastic shavings, loofah, and waste iron shavings, generated during the processing of plastic, crop, and steel. At the same time, a 91 d experiment was performed for real wastewater treatment, and a satisfactory removal performance was obtained, with average removal rates of COD, TP, NH4+-N, TN, and SS being 83.3%, 89.6%, 93.8%, 74.7%, and 94.0%, respectively. Through microscope observation, a large number of microorganisms were attached to the surface of the fillers, which was conducive to the simultaneous removal of nitrogen and phosphorus. The micro-electrolysis of waste iron shavings can produce Fe2+ and Fe3+, which would combine with PO43− to form Fe3(PO4)2 and FePO4 precipitates, enhancing the removal of phosphorus. In addition, the filled fillers have an excellent physical filtering effect, which can reduce the effluent SS. The magic filter achieves both the recycling of wastes and the treatment of wastewater.

Prevention of indoor air pollution through design and construction certification–A review of the sick building syndrome conditions

Indoor quality is an important and necessary concern towards indoor use, which sustains the health of the occupants. Indoor health is the resultant of exposure to all building materials, the contents of room equipment, occupant activities, and the ability of the space to eliminate negative effects on life. This paper adequately describes sources of pollutant exposure, pollutant movement, biological processes, health impacts, all of which can cause Sick Building Syndrome (SBS). Furthermore, indoor depollution measures to counteract SBS need to be carried out at the stages of building design and construction. Based on the interests and needs, here it is necessary to propose a certification of potential SBS at the design and construction stages. Thus, SBS responsibilities can be proportionately distributed to designers, contractors, and building users.

Abstract WP111: Deployment Of Portable, Bedside, Low-field Magnetic Resonance Imaging In The Emergency Department To Evaluate Patients With Acute Stroke

Background and Aims: MRI is critical for diagnosing acute stroke and guiding candidate selection for potential reperfusion therapy. However, rapid stroke evaluation using MRI is often dissuaded by the time required for patients to travel to access-controlled, high-field (1.5-3T) systems. Advances in low-field MRI enable the acquisition of clinically valuable images at the bedside. We report neuroimaging in patients presenting to the Emergency Department (ED) with stroke symptoms using a low-field portable MRI (pMRI) device. Methods: A 64mT pMRI device was deployed in the Yale-New Haven Hospital ED from August 2020 to July 2021. Patients presenting as a “Stroke Code” or “Intracranial Hemorrhage Alert” with no MRI contraindications were scanned. Exams were performed at the bedside, in the vicinity of ED room equipment. Research staff acquired imaging via tablet, with images available immediately after acquisition. Sequences obtained and axial scan times (in minutes) included T1-weighted imaging (4:54), T2-weighted imaging (7:03), fluid-attenuated inversion recovery imaging (9:31), and diffusion-weighed imaging with apparent diffusion coefficient mapping (9:04). Patients’ demographic information, hours from the time of patients' last known normal (LKN) to time of scan, and discharge diagnoses (determined from final imaging interpretation) were assessed. Results: pMRI exams were obtained on 54 patients (28 females, 51.9%; median age 71 years, 20-98 years). Discharge diagnoses included ischemic stroke (42.6%) no intracranial abnormality (31.5%), intraparenchymal hemorrhage (7.4%), atherosclerosis (7.4%), tumor (5.6%), subdural hematoma (3.7%), and intraventricular hemorrhage (1.9%). Patient LKN times ranged from 2 to 144 hours (median of 12 hours; 3 patients with no LKN excluded). The pMRI did not interfere with ED equipment and no significant adverse events occurred. Conclusion: We report the use of a pMRI for bedside neuroimaging in the ED. This approach suggests that pMRI may be viable for supporting rapid diagnosis and treatment candidate selection in patients presenting with stroke symptoms to the ED.

Simplified and Detailed Analysis of Data Center Particulate Contamination at Server and Room Level Using Computational Fluid Dynamics

Abstract Continuous rise in cloud computing and other web-based services propelled the data center proliferation seen over the past decade. Traditional data centers use vapor-compression-based cooling units that not only reduce energy efficiency but also increase operational and initial investment costs due to involved redundancies. Free air cooling and airside economization can substantially reduce the information technology equipment (ITE) cooling power consumption, which accounts for approximately 40% of energy consumption for a typical air-cooled data center. However, this cooling approach entails an inherent risk of exposing the ITE to harmful ultrafine particulate contaminants, thus, potentially reducing the equipment and component reliability. The present investigation attempts to quantify the effects of particulate contamination inside the data center equipment and ITE room using computational fluid dynamics (CFD). An analysis of the boundary conditions to be used was done by detailed modeling of ITE and the data center white space. Both two-dimensional and three-dimensional simulations were done for detailed analysis of particle transport within the server enclosure. An analysis of the effect of the primary pressure loss obstructions like heat sinks and dual inline memory modules inside the server was done to visualize the localized particle concentrations within the server. A room-level simulation was then conducted to identify the most vulnerable locations of particle concentration within the data center space. The results show that parameters such as higher velocities, heat sink cutouts, and higher aspect ratio features within the server tend to increase the particle concentration inside the servers.

Minimally invasive surgery for intradural extramedullary spinal cord pathologies: A case series and technical note

BackgroundIntradural spinal cord pathologies have traditionally been managed with open surgical procedures and require the completion of a durotomy. Minimally invasive techniques are emerging as alternative procedures with the goal of reducing complications, but often require specialized equipment with additional training. MethodsWe conduct a single institution retrospective review from 2016 to 2019 of patients undergoing minimally invasive durotomy closure for intradural extramedullary pathologies using a novel technique that utilizes standard operating room equipment. This cohort is compared to a cohort of patients treated with a traditional open approach. ResultsPatients treated with minimally invasive surgery (MIS) had no statistically significant differences in baseline characteristics compared to patients treated with open procedures. Patients treated with MIS had decreases in complication rates, estimated blood loss, and length of stay in the hospital compared to the patients treated with open procedures, but these differences did not reach levels of statistical significance. ConclusionsOur novel MIS technique for intradural extramedullary pathologies appears to be safe and effective in creating a watertight dural closure using standard operating room equipment, while avoiding the costs and training associated with specialized equipment and possibly improving surgical outcome measures when compared to open approaches.

Development and efficacy testing of a portable negative pressure enclosure for airborne infection containment.

ObjectivesTo overcome the shortage of personal protective equipment and airborne infection isolation rooms (AIIRs) in the COVID‐19 pandemic, a collaborative team of research engineers and clinical physicians worked to build a novel negative pressure environment in the hopes of improving healthcare worker and patient safety. The team then sought to test the device's efficacy in generating and maintaining negative pressure. The goal proved prescient as the US Food and Drug Administration (FDA) later recommended that all barrier devices use negative pressure.MethodsInitially, engineers observed simulations of various aerosol‐ and droplet‐generating procedures using hospital beds and stretchers to determine the optimal working dimensions of the containment device. Several prototypes were made based on these dimensions which were combined with filters and various flow‐generating devices. Then, the airflow generated and the pressure differential within the device during simulated patient care were measured, specifically assessing its ability to create a negative pressure environment consistent with standards published by the Centers for Disease Control and Prevention (CDC).ResultsThe portable fans were unable to generate any airflow and were dropped from further testing. The vacuums tested were all able to generate a negative pressure environment with the magnitude of pressure differential increasing with the vacuum horsepower. Only the 3.5‐horsepower Shop‐Vac, however, generated a −3.0 pascal (Pa) pressure gradient, exceeding the CDC‐recommended minimum of −2.5 Pa for AIIRs.ConclusionA collaborative team of physicians and engineers demonstrated the efficacy of a prototype portable negative pressure environment, surpassing the negative pressure differential recommended by the CDC.

Zadovoljstvo i nezadovoljstvo gostiju u hotelima u Vrnjačkoj Banji - analiza stanja tokom pandemije COVID-19

The development of domestic tourism is marked as one of the positive changes caused by the COVID-19 virus pandemic. The always popular spa destinations in Serbia are becoming more and more visited. Accordingly, it is necessary to determine which factors lead to the satisfaction or dissatisfaction of domestic guests in hotels. This paper will examine the satisfaction and dissatisfaction of hotel guests who shared their experiences through reviews on the Booking.com platform. The sample consisted of hotel guests in Vrnjačka Banja, because this destination stands out as the most visited during the coronary virus pandemic in Serbia. During August 2021, a total of 533 reviews of domestic tourists were collected, and the analysis of the obtained data was performed with the help of the SPSS 20 social science package and the RapidMiner data mining software. The analysis of the results revealed that a total of 8 factors affected the satisfaction of hotel guests during the corona virus pandemic, while a total of 5 factors influenced the dissatisfaction. The obtained results will help hotel managers in creating adequate strategies to improve those factors that are a source of dissatisfaction of guests such as the service provided, room equipment or additional facilities.

Analysis of the equipment of school medical offices in the context of the studied regions in the Republic of Kazakhstan

Background. The European Region's school attendance rate is almost 100%, providing a unique opportunity to reach the entire population of school-age children and adolescents, regardless of their socioeconomic status. By providing equal access to opportunities in health promotion, preventive care, and health surveillance, growth, and development, school health services significantly contribute to social equity by optimizing health care and improving education, improving the academic achievement of all children and teenagers.According to the World Bank, global enrollment rates in primary education are 89%. Educational institutions are a unique platform for implementing long-term and large-scale programs to protect the health of children and adolescents. Thus, the school health system can be an institutional way of covering the health needs of most school-age children and adolescents daily.The aim. The analysis aims to assess the equipment of medical rooms in schools in Kazakhstan to provide the required assistance to students.Methods. We analyzed the medical offices of 10 schools in Astana, Akmola, Kyzylorda, East Kazakhstan, and the Atyrau regions.Results. The share of medical offices that meet the sanitary and epidemiological requirements in the country is 85.5%. In Astana, the share of medical offices that meet the requirements of sanitary and epidemiological standards is 99.1%. The indicators of compliance with the sanitary and epidemiological requirements of medical offices in the East Kazakhstan (84.6%) and Atyrau (80.4%) regions were lower than the republican value (14).Conclusion. The health care system has sanitary and hygienic standards for educational institutions regarding lighting, ventilation, heating, size, and location. These rules are observed throughout most of the country.Key words: Health Services, School, School Health Promotion, School-Based Health Services, School-Based Services, Services, School Health.

Usefulness of Radiation Protection Cloths in Fluoroscopy with Clean Areas

Lowering the dose limit for the lens of the eye incorporated into the Regulation on Prevention of Ionizing Radiation Hazards, effective on April 2021, and dose reduction will become more and more important in the field of radiation. Radiation protective cloth is used as a protective equipment in fluoroscopy rooms. Although it is usually used to protect staff from radiation exposure during endoscopic retrograde cholangiopancreatography, we investigated whether there is a way to use it for procedures in clean areas. Assuming ureterostomy fistula replacement in urology, the protective cloth was suspended on the side of the patient's head and posterior aspect of the tube, and the distance between the anterior aspect of the X-ray tube and the patient's foot was 55 cm. As a result of measuring the dose rate, a 10% dose reduction was obtained for the lens of the eye of the surgeon, and the distribution of air dose rate in the examination room was significantly reduced. Although scattered radiation from the radiation protection cloth appeared in some areas, the radiation dose to the patient was reduced throughout the body, and a high degree of radiation protection was obtained, especially for the lens of the eye. It is expected that the radiation protection cloths may be useful even when the length of the cloths is limited due to the cleanliness of the area.

Review of the Economics of Surgical Treatment Options for Benign Prostatic Hyperplasia.

The goal of this paper is to review the literature detailing US-based analyses for cost and cost-effectiveness of surgical treatment options for benign prostatic hypertrophy (BPH) and associated LUTS. TURP offers the greatest degree of symptom improvement with its associated costs dependent upon operating room time, equipment, and length of hospital stay. Other studied surgical treatment modalities, including transurethral laser ablative, thermal ablative, and convective water vapor modalities as well as prostatic urethral lift and transabdominal procedures, generally carry higher costs and lower cost-effectiveness in both inpatient and outpatient settings, with specific exceptions. Compared to TURP, HoLEP and Greenlight PVP have demonstrated superior cost-effectiveness for mild, moderate, and severe BPH. Convective water vapor ablation, as with transurethral microwave/thermoablative therapies, has been observed to be less expensive per procedure than TURP on average. However, it conferred lower degrees of IPSS symptom improvement. Moreover, compared to TURP, prostatic artery embolization has demonstrated lower average costs coupled with inferior objective improvement in maximal flow rate, prostate volume reduction, PSA decline and minimal improvement in IPSS subjective outcome measures. For this review, selection bias, asymmetric patient groups, issues with study aggregation, and understudied cost contributors (including retreatment costs, long-term durability of symptom relief, recovery time, and work productivity limitations) were identified as key limitations. Nevertheless, this overview takes important steps to understand the costs of surgical treatment options for BPH, allowing for more informed clinical and policy decisions.

ОСОБЛИВОСТІ БУХГАЛТЕРСЬКОГО ОБЛІКУ ВИТРАТ ТУРИСТИЧНОГО ТА ГОТЕЛЬНО-РЕСТОРАННОГО БІЗНЕСУ

The article identifies common and distinctive features in the areas of activity, composition and cost accounting of tourism and hotel and restaurant services. To this end, the study highlights and clarifies such economic categories as "travel agent costs", "tour operator costs", "hotel costs" and "restaurant costs", their classification and place in accounting, identified and justified choice of methods of accounting for travel and hotel and restaurant enterprises, considered correspondence of accounts, through which the accounting of costs of these enterprises, the conditions for the application of 8 or 9 class of the Chart of Accounts for these enterprises. Creation of the tour by the tour operator causes the occurrence of costs, which are accounted for in accounts 23 "Production", sub-account "Production of tourist services", 91 "General production costs", sub-account "General production costs of tourist services", 92 "Administrative costs", 93 "Sales costs" , 94 "Other operating expenses", 95 "Financial expenses", sub-account 903 "Cost of sold works and services", sub-account of the second order "Cost of sold tourist services". In accounting, the cost of hotel services is formed on account 23 "Production", from where it is debited to sub-account 903 "Cost of work performed and services". In this case, if the hotel has separate units (laundry, dry cleaning, storage room, etc.), the costs of their activities can be accounted for in separate sub-accounts opened for account 23. Accounting for other operating expenses of the hotel is on accounts 91, 92, 93, 94. The specificity of the restaurant business is that it has features of production, retail and services, which is not a characteristic feature of most businesses in other sectors of the economy. Among the problems associated with the accounting of the restaurant business, we can highlight the composition of costs, methods of accounting for certain types of costs (including the cost of salaries to waiters, depreciation and maintenance of trade equipment, advertising costs, rental costs, depreciation and amortization and maintenance of premises and dining room equipment and others).

Computer Laboratory Asset Management System with Analytics

With the development of computer information technology, the information revolution permeates every corner of life. Colleges and universities are the frontiers of information development, and their hardware infrastructure construction is relatively perfect. Due to the large number of people in colleges and universities, the computer room and computer training room equipment are also required. Traditional computer asset management methods are inefficient, especially the management of computer laboratory assets, which is not standardized and difficult to manage and count online. Therefore, we need to develop a set of online computer training rooms asset management system, equipment management, assets input, assets, to solve the online query, asset service, asset leasing, fault statistics, maintenance records, etc., at the same time, through the system specification work of the staff of computer room, computer lab asset management more standardized and efficient.

FEASIBILITY STUDY OF WOOD WORKSHOP SPACES CONTRUCTION AND PROPERTY BUSINESS EXPERTISE STUDY AT STATE VOCATIONAL SCHOOL 1 PALANGKA RAYA

The purpose of this study was to determine the feasibility of the wood workshop space, wood workshop lighting system, and woodworking furniture and equipment at SMK N 1 Palangka Raya based on the standards required by Permendiknas No. 40 of 2008 and SNI 03-6575-2001. This is done to provide convenience and feasibility for users. The results of this study are (1) the wood workspace area of SMK N 1 Palangka Raya does not meet the standard with an area of 198 m² which is smaller than the standard of 256 m² with an achievement percentage of 77.34%, the area of the equipment storage room and the wood workshop instructor room has meet the standard with an area of 72 m² larger than the standard of 48 m² with an achievement percentage of 150%, the overall area of the wood workshop does not meet the standard with an area of 270 m² smaller than the standard of 304 m² with an achievement percentage of 88.8%. (2) The level of lighting in the wood workshop room at SMK N 1 Palangka Raya has not met the standard, namely min 500 lux with a lighting level of 400 lux in the morning with an achievement percentage of 80%, during the day 411 lux with an achievement percentage of 82%, in the afternoon day of 408 lux with an achievement percentage of 81%. (3) Equipment and furniture for the wood workshop room at SMK N 1 Palangka Raya, single station equipment does not meet the standard with the number of equipment that meets the standard is 1 type of tool and 20 types of tools that meet the standard with a size of achievement of 4.76%, equipment double station there are 3 types of tools that meet the standards and 9 types of tools that do not meet the standards with a size of 16.66% standard achievement, workshop furniture there are 3 types of furniture that do not meet the standards and 4 types of furniture that meet the standards with a large standard achievement are 42.85%.

Structural and Process Data on Radiological Imaging in the Treatment of Severely Injured Patients - Results of a Survey of Level I and II Trauma Centers in Germany.

Systematic data collection regarding the integration of radiology as well as structural and process characteristics of radiological diagnostics of severely injured patients in Germany using a structured questionnaire. Personal contact with all certified Level I and Level II Trauma Centers in Germany. Data on infrastructure, composition of the trauma room team, equipment, and data on the organization/performance of primary major trauma diagnostics were collected. With a participation rate of 46.9 % (n = 151) of all German trauma centers (N = 322), a solid database is available. There were highly significant differences in the structural characteristics incl. CT equipment between the level I and II centers: In 63.8 % of the level II centers, the CT unit was located more than 50 m away from the trauma room (34.2 % in the level I centers). A radiologist was part of the trauma room team in 59.5 % of level II centers (level I 88.1 %). Additionally, highly significant differences were found comparing 24-h provision of other radiologic examinations and interventions, such as MRI (level II 44.9 %, level I 92.8 %) and angiography (level II 69.2 %, level I 97.1 %). Heterogeneous structural and process characteristics of the diagnosis of severely injured patients in Germany were revealed, with highly significant differences between level I and level II centers. · This is the first study on the diagnostic reality of radiology in severely injured patients in Germany. Despite a high level of standardization, significant differences were observed.. · Ernstberger A, Reske SU, Brandl A et al. Structural and Process Data on Radiological Imaging in the Treatment of Severely Injured Patients - Results of a Survey of Level I and II Trauma Centers in Germany. Fortschr Röntgenstr 2022; 194: 505 - 514.

The case for digital image capture during procedures.

The case for digital image capture during procedures.

THE IMPACT OF TARGETED TRAINING OF MEDICAL INTERNS ON THE SURVIVAL OF CARDIAC ARREST IN THE EMERGENCY ROOM

Introduction:The prognosis of patients with cardiac arrest is closely related to the quality of cardiopulmonary resuscitation (CPR). The aim of this work was to assess the impact of targeted training on CPR, in accordance with the latest international recommendations, on the management of cardiac arrests in SAUV. Methods:This is a prospective study carried out between January 1 and December 31, 2011 at the SAUV of Ibn Sina University Hospital in Rabat, including all adult patients who experienced cardiac arrest after admission. The main primary objective is to evaluate the impact of targeted training of medical interns on the survival of cardiac arrest in the ER expressed by the Hospital Discharge Survival (HDS) rate. Secondary objectives include the rate of recovery of circulatory activity (RCA), 48-hour survival, and quality of CPR performance. Results:342 patients were included, 159 before and 183 after training. There was no significant difference in terms of recovery from spontaneous circulation, 48h survival or discharge rate at home without sequelae. On the other hand, there was a statistically significant improvement in all the quality criteria for performing CPR. Conclusion:This work shows that the introduction of short training courses such improves the quality of CPR. The lack of impact on the improvement of patient survival seems to be related to numerous shortcomings, in particular basic medical training in emergency medicine, organization and protocolization of care, equipment of emergency rooms, supervision of emergency clerkship and the existence of a CA national registry. These are all areas to be developed in order to improve the prognosis of CA in our hospital structure.

Comparative Analysis of Actual Cost and INA CBG Rate in Diabetic Gangrene Inpatients

Background: Diabetic gangrene is a complication of diabetes mellitus that imposes a substantial financial burden on patients and their families as well as the health care system. Objective: To determine the total cost of disease, and the difference between real cost and INA CBG rate for diabetic gangrene inpatients from January - December 2017 at Universitas Airlangga Hospital, Surabaya Methods: The study was conducted retrospectively by using a total sampling method. The perspective used was the hospital perspective. This study's direct medical costs were laboratory, drug and consumable medical device costs, medical equipment rental, radiology examination, red cross, oxygen, service, and room costs. Data analysis was performed using an independent samples t-test. Results: The results showed that 148 patients met the inclusion criteria. The total real cost of diabetic gangrene inpatients at Universitas Airlangga Hospital in 2017 was IDR 1,339,949,381, and the total INA CBG rate for inpatients with diabetic gangrene was IDR 1,365,047,500. The difference was (p = 0.000) between real cost and INA CBG rate. Conclusion: There is a difference between the actual cost and the INA CBG rate for diabetic gangrene inpatients.

Evaluation of HMDs by QFD for Augmented Reality Applications in the Maxillofacial Surgery Domain

Today, surgical operations are less invasive than they were a few decades ago and, in medicine, there is a growing trend towards precision surgery. Among many technological advancements, augmented reality (AR) can be a powerful tool for improving the surgery practice through its ability to superimpose the 3D geometrical information of the pre-planned operation over the surgical field as well as medical and instrumental information gathered from operating room equipment. AR is fundamental to reach new standards in maxillofacial surgery. The surgeons will be able to not shift their focus from the patients while looking to the monitors. Osteotomies will not require physical tools to be fixed on patient bones as guides to make resections. Handling grafts and 3D models directly in the operating room will permit a fine tuning of the procedure before harvesting the implant. This article aims to study the application of AR head-mounted displays (HMD) in three operative scenarios (oncological and reconstructive surgery, orthognathic surgery, and maxillofacial trauma surgery) by the means of quantitative logic using the Quality Function Deployment (QFD) tool to determine their requirements. The article provides an evaluation of the readiness degree of HMD currently on market and highlights the lacking features.

97 Decreasing invasive urinary tract infection screening in a paediatric emergency department: A quality improvement initiative

Abstract Primary Subject area Emergency Medicine - Paediatric Background Fever is a common presentation among children coming to the Emergency Department (ED) and a urinary tract infection (UTI) often needs to be excluded. Sterile techniques, like catheterization, are invasive, can be traumatizing to children, and are time consuming to complete. A two-step approach has been shown to reduce the catheterization rate in febrile, young children without unintended consequences. Objectives Our aim was to implement a two-step approach for UTI screening in febrile children 6-24 months in order to decrease unnecessary urine catheterizations by 50% without impacting ED length of stay (LOS) or return visits (RVs). Design/Methods After engaging key stakeholders and a nursing champion, we created a process map to understand the current urine collection process in our ED, and areas for targeted improvement. Using the model for improvement, we adopted a 2-step pathway for a suspected UTI in children 6-24 months as our change idea. The pathway involved identifying children who met inclusion criteria for UTI screening, followed by urine bag application and urinalysis (UA) if clinically indicated. Only if the UA was positive, a second urine sample was collected via catheterization, for repeat UA and culture. Through multiple PDSA cycles, our pathway was implemented in the ED along with concurrent staff education. The outcome measure was the rate of ED urine catheterizations. Process measures included the total number of urine cultures sent to microbiology and percent positivity. The balancing measures included ED LOS and RVs. Results Since project initiation in July 2019, the ED catheterization rate decreased from 73% to 53% (Figure 1) and the number of urine cultures sent to Microbiology decreased by 23%. The number of urine cultures sent to Microbiology decreased by 23% with a mild improvement in the positivity rate by 2% (Figure 2). There was no significant change in RVs. There was a slight 10-min increase in ED LOS, most likely confounded by the COVID pandemic. Conclusion Using improvement methodology, we successfully decreased the number of unnecessary catheterizations in children and the number of urine cultures sent to microbiology. Further refinements to our intervention are ongoing and include optimizing urine screening equipment in patient rooms, poster reminders, re-education for providers, and introducing a parent resource explaining the 2-step pathway. This improvement work is also being spread to the paediatric wards and can easily be adopted by other paediatric centres. It has also been adapted by the Choosing Wisely hospital campaign.