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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; [email protected]

Abstract

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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

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