Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-01T02:15:21.870Z Has data issue: false hasContentIssue false
  • English
  • Français

Emergency department visual urinalysis versus laboratory urinalysis

Published online by Cambridge University Press:  21 May 2015

James C. Worrall
James C. Worrall*
Affiliation:
Department of Emergency Medicine, University of Ottawa, Ottawa, Ont., and the Department of Emergency Medicine, Cornwall Community Hospital, Cornwall, Ont.
*
Department of Emergency Medicine, Cornwall Community Hospital, 840 McConnell Ave., Cornwall ON K6H 5S5; jworrall@rogers.com

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective:

The primary objective of this study was to compare the results of nurse-performed urinalysis (NPU) interpreted visually in the emergency department (ED) with laboratory-performed urinalysis (LPU) interpreted by reflectance photometry.

Methods:

This was a prospective observational study based on a convenience sample from my emergency practice. Emergency nurses, who were unaware of the study, performed usual dipstick analysis before sending the same urine sample to the laboratory for testing.

Results:

Of 140 urinalyses performed during the study period, 124 were suitable for analysis. When compared with the reference standard LPU, the NPU had an overall sensitivity of 100% (95% confidence interval [CI] 95%–100%) and a specificity of 49% (95% CI 33%–65%) for the presence of any 1 of blood, leukocyte esterase, nitrites, protein, glucose or ketones in the urine. Of 20 falsely positive NPUs, 18 were a result of the nurse recording 1 or more components as “trace” positive.

Conclusion:

Although NPU does not yield identical results to LPU, a negative LPU is expected when the initial NPU in the ED is negative.

Keywords

urinalysisemergency departmentpoint-of-care testinglaboratory delays
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 11 , Issue 6 , November 2009 , pp. 540 - 543
Copyright
Copyright © Canadian Association of Emergency Physicians 2009

References

REFERENCES

1.Kerr, S, Marshall, C, Sinclair, D. Emergency physicians versus laboratory technicians: Are the urinalysis and microscopy results comparable? A pilot study. J Emerg Med 1999;17: 399–404.CrossRefGoogle ScholarPubMed
2.Ohly, N, Teece, S. Accuracy of negative dipstick urine analysis in ruling out urinary tract infection in adults. Emerg Med J 2003;20:362–3.Google Scholar
3.Doley, A, Nelligan, M. Is a negative dipstick urinalysis good enough to exclude urinary tract infection in paediatric emergency department patients? Emerg Med (Fremantle) 2003;15: 77–80.Google Scholar
4.Lammers, RL, Gibson, S, Kovacs, D, et al. Comparison of test characteristics of urine dipstick and urinalysis at various test cut off points. Ann Emerg Med 2001;38:505–12.Google Scholar
5.Sultana, RV, Zalstein, S, Cameron, P, et al. Dipstick urinalysis and the accuracy of the clinical diagnosis of urinary tract infection. J Emerg Med 2001;20:13–9.CrossRefGoogle ScholarPubMed
6.Nagurney, JT, Brown, D, Chang, Y, et al. Use of diagnostic testing in the emergency department for patients presenting with non-traumatic abdominal pain. J Emerg Med 2003;25:363–71.CrossRefGoogle ScholarPubMed
7.Dean, A, Lee, D. Bedside laboratory and microbiologic procedures. In: Roberts, J, Hedges, J, editors. Clinical procedures in emergency medicine, 4th ed. Philidelphia (PA): Saunders; 2004.p. 1392–9.Google Scholar
8.Peele, JD, Gadsden, R, Crews, R. Semi-automated vs. visual reading of urinalysis dipsticks. Clin Chem 1977;23:2242–5.CrossRefGoogle ScholarPubMed
9.Holland, DJ, Bliss, KJ, Allen, CD, et al. A comparison of chemical dipsticks read visually or by photometry in the routine screening of urine specimens in the clinical microbiology laboratory. Pathology 1995;27:91–6.CrossRefGoogle ScholarPubMed
10.Pritchard, V, Levernier, J. Multistix versus laboratory urinalysis in the detection of urinary tract infection. J Gerontol Nurs 1991;17:39–42.Google Scholar