RESUMO
PURPOSE: The purpose of this study was to compare bacteriological urinalysis findings using 3 urinary sample collection methods (clean stoma catheterization, urine dripping from the stoma, urine collected from the clean urostomy pouch) in ileal conduit urinary diversion patients. DESIGN: Randomized controlled trial. SAMPLE AND SETTING: Twenty-seven patients with ileal conduit urinary diversion from an outpatient urology clinic were enrolled; 9 patients were seen twice, for a total of 36 subjects and comparisons. METHODS: Data were collected during a clinic visit by a trained research nurse. Patients were randomized into 2 groups: group A had the first urine sample collected by clean stoma catheterization, followed by sample collection by urine dripping from the stoma; group B had the first urine sample collection by urine dripping from the stoma, followed by sample collected by clean stoma catheterization. All patients had a third urine sample collected from a factory-clean urostomy pouch. Bacteriological urinalysis findings were compared among methods. Descriptive analyses were summarized using mean, percentage, and frequency. The mean ages of the patients between the groups were compared with the t test. Other between-group comparisons were performed using the Fisher exact test. Urinary culture finding differences among the same patients were evaluated using the McNemar test. Sensitivity and specificity of the different urine sample collection methods were calculated assuming urine sample collection by catheterization as a reference method. RESULTS: Uropathogen bacteria were detected in urinary culture in 16 of 36 samples (44%) collected by clean stoma catheterization, 15 of 36 samples (42%) collected by urine dripping directly from the stoma, and 13 of 35 samples (37%) collected from the clean urostomy pouch. Significant differences among the urine collection methods were not detected. Assuming catheterization as the most reliable method of sample collection, the sensitivity and specificity of the urine dripping from stoma collection method were 81.3% and 90.0%, respectively. The sensitivity and specificity of the urostomy pouch collection method were 73.3% and 90.0%, respectively. Among the same patients, there were no significant differences in the incidence of uropathogen bacteria when clean stoma catheterization was compared with urine dripping from the stoma and urostomy pouch methods. CONCLUSION: This study provides clinically relevant information regarding urine collection methods in ileal conduit patients. Urinary sample collection by urine dripping directly from the stoma or collected from a clean urostomy pouch provided similar uropathogen bacteria findings compared with sample collection by clean stoma catheterization.
Assuntos
Manejo de Espécimes/normas , Derivação Urinária/enfermagem , Coleta de Urina/normas , Idoso , Idoso de 80 Anos ou mais , Feminino , Finlândia , Humanos , Masculino , Pessoa de Meia-Idade , Manejo de Espécimes/enfermagem , Urinálise/enfermagem , Coleta de Urina/enfermagemRESUMO
June Rogers and Caroline Saunders review current evidence and best practice regarding obtaining a urine specimen from children.
Assuntos
Manejo de Espécimes/métodos , Urinálise/métodos , Infecções Urinárias/diagnóstico , Fatores Etários , Criança , Pré-Escolar , Fraldas Infantis , Drenagem/enfermagem , Humanos , Lactente , Enfermagem Pediátrica/métodos , Guias de Prática Clínica como Assunto , Manejo de Espécimes/instrumentação , Manejo de Espécimes/enfermagem , Urinálise/instrumentação , Urinálise/enfermagem , Cateterismo Urinário/enfermagem , Infecções Urinárias/microbiologiaAssuntos
Urinálise/enfermagem , Infecções Urinárias/diagnóstico , Infecções Urinárias/enfermagem , Doenças Urológicas/diagnóstico , Doenças Urológicas/enfermagem , Adolescente , Criança , Pré-Escolar , Humanos , Lactente , Microscopia/métodos , Valor Preditivo dos Testes , Kit de Reagentes para Diagnóstico , Manejo de Espécimes/métodos , Manejo de Espécimes/enfermagem , Infecções Urinárias/urinaRESUMO
Elimination of urine is an essential bodily function, but independence in this activity may be affected by physical and mental disability. Part 1 of this article discusses the anatomy and physiology of the renal and urinary tract and the production of urine. Urinalysis is a vital nursing assessment and the collection of specimens and the range of tests undertaken are outlined. Assisting patients to use the toilet, commode or bedpan is an essential nursing skill. The importance of sensitivity, empathy and moving and handling risk assessment is discussed, and the assessment and management of urinary tract infection and urinary tract stones are addressed. The importance of prevention of cross infection for nurses and patients is highlighted throughout the article.
Assuntos
Cálculos Urinários , Infecções Urinárias , Fenômenos Fisiológicos do Sistema Urinário , Sistema Urinário/anatomia & histologia , Micção/fisiologia , Técnicas de Diagnóstico Urológico/enfermagem , Feminino , Humanos , Rim/anatomia & histologia , Rim/fisiologia , Remoção/efeitos adversos , Masculino , Néfrons/anatomia & histologia , Néfrons/fisiologia , Papel do Profissional de Enfermagem , Avaliação em Enfermagem , Prevenção Primária , Medição de Risco , Urinálise/enfermagem , Cálculos Urinários/diagnóstico , Cálculos Urinários/terapia , Infecções Urinárias/diagnóstico , Infecções Urinárias/terapia , UrodinâmicaRESUMO
To determine whether urine color, as measured by a color chart, might be a valid indicator of hydration status in frail nursing home residents, this study tested the associations between urine color and urine specific gravity. This is a descriptive correlational study set in seven nursing homes in eastern Iowa. Ninety-eight nursing home residents > or =65 years of age participated. Exclusion criteria for the study included: unstable congestive heart failure or diabetes, documented renal disease, hyponatremia (serum sodium <135 meq/L), terminal illness, acutely confused/delirious or urinary tract infection at baseline, and gastrostomy-tube dependence. Weekly urine specimens were collected. Ucol was measured first, using a urine color chart. Usg was determined using the Chemstrip Mini UA Urine Analyzer. Week-by-week Spearman rank order correlations between urine color and specific gravity for the total sample (n=98) ranged from r(s) = 0.3 - 0.7, p < .01; the PROC mixed model was significant, p < .01. In subgroup analyses (n=78), all females (r(s) = 0.67, p = .01) and both males (r(s) = 0.53, p = .01) and females (r(s) = 0.72, p =.01) with adequate renal function (Cockcroft-Gault estimated creatinine clearance [CrCl] values of > or =50 ml/min) had significant associations between average urine color and average Usg. Females with mild renal impairment (CrCl between 30 and 50 ml/min) also had significant associations between Ucol and Usg (r(s) = .64, p < .01). Ucol averaged over several individual readings offers another tool in assessing hydration status in Caucasian nursing home residents with adequate renal function measures by estimated CrCl values.
Assuntos
Colorimetria/instrumentação , Desidratação , Avaliação Geriátrica/métodos , Avaliação em Enfermagem/métodos , Urinálise/instrumentação , Idoso , Idoso de 80 Anos ou mais , Colorimetria/normas , Creatinina/urina , Desidratação/diagnóstico , Desidratação/urina , Feminino , Humanos , Iowa , Masculino , Taxa de Depuração Metabólica , Avaliação em Enfermagem/normas , Pesquisa em Avaliação de Enfermagem , Casas de Saúde , Variações Dependentes do Observador , Fitas Reagentes , Índice de Gravidade de Doença , Caracteres Sexuais , Gravidade Específica , Estatísticas não Paramétricas , Urinálise/enfermagem , Urinálise/normasRESUMO
Weekly measurement of urinary pH has become a standard part of long-term catheter management in many parts of the UK. The common problem of catheter encrustation is caused by urease-producing bacteria which also tend to produce alkaline urine. To determine if urinary pH changes in individual catheter users provided enough information for pH monitoring to aid in catheter management, an analysis of the literature was combined with a study of the urinary pH and catheter blockage patterns in 20 catheter users colonized with urease-producing bacteria. It was found that weekly pH measurement does not aid in the diagnosis or management of catheter encrustation. As such, this practice cannot be recommended.
Assuntos
Infecções Bacterianas/diagnóstico , Cateteres de Demora/efeitos adversos , Concentração de Íons de Hidrogênio , Urinálise/métodos , Cateterismo Urinário/efeitos adversos , Infecções Urinárias/diagnóstico , Infecções Bacterianas/etiologia , Infecções Bacterianas/urina , Biofilmes , Pesquisa em Enfermagem Clínica , Cristalização , Falha de Equipamento , Avaliação em Enfermagem/métodos , Valor Preditivo dos Testes , Estudos Prospectivos , Reprodutibilidade dos Testes , Fatores de Risco , Fatores de Tempo , Urease/metabolismo , Urinálise/enfermagem , Urinálise/normas , Cateterismo Urinário/enfermagem , Infecções Urinárias/etiologia , Infecções Urinárias/urinaRESUMO
In vitro diagnostic point-of-care testing (IVDPCT) can improve patient care but improvements can only be properly realised by adequate management in order to ensure high-quality test results. Nurses perform IVDPCT in all areas of clinical practice, from intensive care units to GP surgeries, using a wide variety of devices ranging from urinalysis strips to blood gas analysers.
Assuntos
Técnicas e Procedimentos Diagnósticos/enfermagem , Sistemas Automatizados de Assistência Junto ao Leito/organização & administração , Gasometria/enfermagem , Automonitorização da Glicemia/enfermagem , Competência Clínica/normas , Tomada de Decisões Gerenciais , Monitoramento de Medicamentos/enfermagem , Humanos , Papel do Profissional de Enfermagem , Recursos Humanos de Enfermagem Hospitalar/educação , Recursos Humanos de Enfermagem Hospitalar/organização & administração , Urinálise/enfermagemAssuntos
Recém-Nascido/urina , Enfermagem Neonatal/métodos , Urinálise/métodos , Urinálise/enfermagem , Hidrolases de Éster Carboxílico/urina , Glicosúria/diagnóstico , Glicosúria/etiologia , Hematúria/diagnóstico , Hematúria/etiologia , Humanos , Cetonas/urina , Microscopia , Nitritos/urina , Proteinúria/diagnóstico , Proteinúria/etiologia , Valores de Referência , Manejo de Espécimes/métodos , Sistema Urinário/embriologia , Urina/química , Urina/citologia , Doenças Urológicas/complicações , Doenças Urológicas/diagnóstico , Doenças Urológicas/urinaRESUMO
The accurate diagnosis of urinary tract infection (UTI) in young children is important for initial management and the prevention of long-term damage to the developing kidney. Various methods are used for urine collection from the non-potty-trained age group, including catheterisation, suprapubic aspiration, clean-catch sampling, adhesive bag sampling and urine collection pads. Research literature was examined to identify which method is most effective. The themes that evolved from the review were parents' and nurses' views on ease of use, reliability of sample obtained and cost-effectiveness. Although not the most convenient method, clean-catch gives more reliable results making it also the most cost effective approach. Change management strategies are required to overcome barriers to research implementation and to ensure best practice.
Assuntos
Enfermagem Pediátrica/métodos , Manejo de Espécimes/métodos , Treinamento no Uso de Banheiro , Urinálise/métodos , Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Pré-Escolar , Análise Custo-Benefício , Fraldas Infantis , Humanos , Lactente , Recursos Humanos de Enfermagem Hospitalar/psicologia , Pais/psicologia , Enfermagem Pediátrica/economia , Reprodutibilidade dos Testes , Manejo de Espécimes/economia , Manejo de Espécimes/enfermagem , Urinálise/economia , Urinálise/enfermagem , Infecções Urinárias/diagnóstico , Infecções Urinárias/urinaRESUMO
Urine analysis is an essential component of patient assessment, which is used for screening, diagnosis and planning care. This article discusses specimen collection and reagent strip testing.
Assuntos
Fitas Reagentes , Urinálise/instrumentação , Urinálise/métodos , Bilirrubina/urina , Glicosúria/urina , Hematúria/urina , Humanos , Concentração de Íons de Hidrogênio , Cetonas/urina , Leucócitos/metabolismo , Nitritos/urina , Proteinúria/urina , Gravidade Específica , Manejo de Espécimes/métodos , Manejo de Espécimes/enfermagem , Urinálise/enfermagem , Urina/química , Urobilinogênio/urinaRESUMO
Urine is a natural waste product of the body and urine testing is a simple and quick way of monitoring disease and identifying new illness. The results from a urine test can prompt a change in a patient's medical management. Urine testing is not a new procedure: as far back as the ancient Egyptians there are descriptions of polyuria. In 7th Century AD, Protosharis suggested that it was important to look at the colour of urine and by 1674 Thomas Willis, a professor at Oxford University, recorded that the urine of his patients with diabetes tasted sweet (Beer, 1996).
Assuntos
Manejo de Espécimes/métodos , Urinálise/métodos , Humanos , Papel do Profissional de Enfermagem , Sistemas Automatizados de Assistência Junto ao Leito , Guias de Prática Clínica como Assunto , Fitas Reagentes , Manejo de Espécimes/instrumentação , Manejo de Espécimes/enfermagem , Manejo de Espécimes/normas , Fatores de Tempo , Urinálise/instrumentação , Urinálise/enfermagem , Urinálise/normas , Urina/citologia , Urina/microbiologiaRESUMO
RATIONALE AND KEY POINTS: This article aims to help nurses to undertake a urinalysis in a safe, timely, effective and patient-centred manner, ensuring privacy and dignity. Urinalysis is a common clinical procedure involving examination of urine to detect problems in the body. ⶠUrinalysis should be carried out by competent healthcare practitioners. ⶠUrinalysis is a simple, cost-effective tool which can be performed for screening, diagnosis and management of conditions, because urine might undergo several changes as an individual becomes unwell. ⶠUrinalysis is an essential component of the holistic and symptomatic assessment of any individual in poor health. ⶠThe healthcare practitioner should explain the procedure to patients. ⶠThe healthcare practitioner should document relevant findings. REFLECTIVE ACTIVITY: Clinical skills articles can help update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: 1. How reading this article will change your practice. 2. The learning points you have identified, and how you can dissesminate these points to your colleagues. 3. Any further learning needs you have identified. Subscribers can upload their reflective accounts at: rcni.com/portfolio.
Assuntos
Urinálise/instrumentação , Urinálise/métodos , Competência Clínica , Humanos , Urinálise/enfermagemRESUMO
The pH of urine is widely recognized as being a major contributory factor in urinary catheter encrustation. What is less widely appreciated is the range of factors that affect the pH of urine, and which therefore affect the reliability and validity of urine pH testing. This article examines the validity of various urinary pH testing methods and discusses the theoretical and practical implications of the uncertainty surrounding their practical value.
Assuntos
Cateteres de Demora , Urinálise/métodos , Cateterismo Urinário , Infecções Bacterianas/etiologia , Infecções Bacterianas/metabolismo , Infecções Bacterianas/prevenção & controle , Cateteres de Demora/efeitos adversos , Infecção Hospitalar/etiologia , Infecção Hospitalar/metabolismo , Infecção Hospitalar/prevenção & controle , Falha de Equipamento , Medicina Baseada em Evidências , Humanos , Concentração de Íons de Hidrogênio , Controle de Infecções/métodos , Manutenção , Avaliação em Enfermagem/métodos , Planejamento de Assistência ao Paciente , Reprodutibilidade dos Testes , Fatores de Risco , Irrigação Terapêutica/métodos , Irrigação Terapêutica/enfermagem , Fatores de Tempo , Urease/fisiologia , Urinálise/enfermagem , Urinálise/normas , Cateterismo Urinário/efeitos adversos , Cateterismo Urinário/enfermagem , Infecções Urinárias/etiologia , Infecções Urinárias/metabolismo , Infecções Urinárias/prevenção & controleRESUMO
Currently elective orthopaedic patients require a microscopy and culture of urine (MSU) to be performed on admission. Between 70-80% of urine cultures are found to be negative for infection, making this practice costly and time consuming. The purpose of this study was to compare the accuracy of a dip stick urine chemistry analyser (Clinitek 50 machine) with a MSU, to detect the presence of nitrites and/or leukocytes in a group of elective orthopaedic surgical patients. methodology: Using a prospective cohort study design all elective orthopaedic patients who met the study criteria were invited to participate. In total 102 patients undergoing total hip or total knee replacement surgery participated. results: Results showed that the prevalence of urinary tract infections in patients undergoing total knee or hip surgery, was 14%. High specificity and negative predictive values for the detection of bacterial growth by dip stick urine chemical analysis were found, especially when either the presence of nitrites or leukocytes was used as an indicator. conclusion: This study has provided valuable baseline data on the accuracy of using photometry techniques as a screening measure, in the detection of UTI, in a sample of orthopaedic patients. While the Clinitek 50 dip stick urine chemistry analyser did not have high sensitivity in identifying those patients with a UTI, it was specific in identifying those patients who did not have an infection. Given the enormous cost in routine screening of these patients and the impact on nursing resources, use of this analyser could have potential nursing resource and financial benefits.
Assuntos
Fotometria/métodos , Fitas Reagentes/normas , Infecções Urinárias/diagnóstico , Infecções Urinárias/urina , Artroplastia de Substituição/efeitos adversos , Pesquisa em Enfermagem Clínica , Análise Custo-Benefício , Educação Continuada em Enfermagem , Procedimentos Cirúrgicos Eletivos/efeitos adversos , Hospitais de Ensino , Humanos , Contagem de Leucócitos , Programas de Rastreamento/economia , Programas de Rastreamento/métodos , Programas de Rastreamento/enfermagem , Técnicas Microbiológicas/economia , Técnicas Microbiológicas/métodos , Nitritos/análise , Recursos Humanos de Enfermagem Hospitalar/educação , Admissão do Paciente , Fotometria/normas , Cuidados Pré-Operatórios/enfermagem , Prevalência , Estudos Prospectivos , Fitas Reagentes/economia , Sensibilidade e Especificidade , Urinálise/economia , Urinálise/métodos , Urinálise/enfermagem , Infecções Urinárias/epidemiologia , Infecções Urinárias/etiologia , Austrália Ocidental/epidemiologiaAssuntos
Avaliação em Enfermagem/métodos , Transtornos Urinários , Idoso , Documentação , Feminino , Avaliação Geriátrica/métodos , Humanos , Masculino , Programas de Rastreamento/métodos , Programas de Rastreamento/enfermagem , Diagnóstico de Enfermagem/métodos , Registros de Enfermagem , Manejo de Espécimes/métodos , Manejo de Espécimes/enfermagem , Fatores de Tempo , Urinálise/métodos , Urinálise/enfermagem , Cateterismo Urinário/métodos , Cateterismo Urinário/enfermagem , Transtornos Urinários/diagnóstico , Transtornos Urinários/enfermagemRESUMO
There is much value in using urine as a diagnostic aid in the critical care setting. As a noninvasive source of data, urine reveals a wealth of information about the body's biochemical status. It is important for critical care nurses to understand the processes that occur in the renal system and to comprehend the depth of information that can be obtained through an analysis of urine. This discussion provides an overview of common urine tests and provides information for nurses about urine collection methods. The discussion will help the critical care nurse describe various urine test procedures, common urine collection methods, nursing interventions, and patient education important to each study.
Assuntos
Cuidados Críticos/métodos , Urinálise/métodos , Urinálise/enfermagem , Aldosterona/urina , Gonadotropina Coriônica/urina , Creatinina/urina , Eletrólitos/urina , Humanos , Hidrocortisona/urina , Testes de Função Hepática , Taxa de Depuração Metabólica , Papel do Profissional de Enfermagem , Educação de Pacientes como Assunto , Proteinúria/urina , Manejo de Espécimes/instrumentação , Manejo de Espécimes/métodos , Manejo de Espécimes/enfermagem , Ácido Úrico/urinaAssuntos
Avaliação em Enfermagem , Urinálise/métodos , Urina/química , Humanos , Urinálise/enfermagemRESUMO
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.