Urinalysis in the Office Laboratory
Condensed reprint from Focus On, 1998, Issue 1
Urinalysis is the most frequently performed test in the physician office laboratory. Consider the following when you perform urinalysis in your laboratory:
- Dipstick and tablet reagent urinalysis (non-automated) are categorized as waived tests by the Centers for Disease Control and Prevention (CDC). You should still implement the recommendations for quality control specified by the reagent manufacturer.
- Urinalysis procedures that incorporate the use of an instrument, or automated urinalysis procedures, are classified as moderate-complexity tests. Two levels of quality control performed each day of testing is the minimum standard for these.
- Urine sediment examination is categorized as moderate complexity. If performed exclusively by a physician, physician=s assistant, nurse practitioner or nurse midwife, this test is categorized as provider-performed microscopy (PPM)
- Explain proper collection techniques to your patients. This is especially true if the urine is to be cultured. Post the collection procedure in the rest room in your office. If the specimen is to be collected at home, provide instructions for collection and storage along with collection container. Always collect urine in a clean, dry container.
- Urine should be tested as soon after collection as possible. If urinalysis cannot be performed within one hour of collection, refrigerate the specimen. Be sure to allow the urine to return to room temperature before analysis.
- Reagents used for urinalysis should be handled exactly as the manufacturer suggests. Reagent strips (or tablets) should be kept in the original bottle with the desiccant. Store in a cool, dry location. Be careful not to touch reagent pads.
- Dip reagent strips (Adipsticks@) completely, but briefly. Read reaction at the appropriate time in a well-lighted area.
- It is important that you read the reaction at the time indicated in the package insert. Exact timing is essential. For example, the urine leukocyte test may yield a false positive result if read too late, while a falsely decreased urine blood test may be reported if it is read too soon.
- Discard any urinalysis reagents and quality control materials that have exceeded the manufacturer=s expiration date.
Your conscientious effort to eliminate factors that can yield erroneous or unreliable results is important for successful urinalysis. Combined with systematic quality control and proficiency testing, these measures help to ensure that your urine reports are the most accurate that you can provide.
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Related Laboratory Websites
- Centers for Medicare and Medicaid Services (CMS)
- CMS Regional Offices Contact List
- Centers for Disease Control and Prevention (CDC)
- TJC (formerly Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
- State Agencies Contact List
- American Society of Clinical Pathology (ASCP)
- Clinical and Laboratory Standards Institute (CLSI)
- Occupational Safety and Health Administration (OSHA)
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