Urine dipsticks use: process standardization from a Human Factors approach
TimeThursday, April 152:00pm - 3:00pm EDT
LocationPatient Safety Research and Initiatives
DescriptionIn Pediatric Emergency Rooms (Pediatric ER), urine dipsticks are requested in many different situations such as febrile syndrome without focus or suspicion of urinary tract infections. Although the diagnosis and treatment of the patients does not depend only on this technology, urine dipsticks have a high negative predictive value and can avoid the completion of additional laboratory tests.
To read the test results, the color of the different dipstick reagents has to be compared with a standard shown in the product package. A relatively high percentage of False Positives (% FP) was detected in the Pediatric ER of our hospital, leading to a lack of confidence in the test with associated extra costs.
To analyze the context, a multidisciplinary Human Factors team accomplished a medical record review to assess the correlation between the urine dipstick results and the additional laboratory tests. As high %FP was confirmed, observations and interviews in the pediatric ER were performed to deeply understand the use process and to detect possible areas of improvement.
As a result, a visual and easy-to-use urine dipstick guide was developed. The document includes instructions for preservation, quality control and use of the strips. To complement that, a sheet for results annotation was designed.
The guide was presented to the Pediatric ER nurse’s aides and the Nursing Supervisor in a one-hour hands on training. Participants feedback was very positive and their suggestions were implemented in the guide and the sheet for results. Both tools are currently used at the Pediatric ER room.