Improving the Quality of Urine Specimens Collected in an Emergency Room

Francine Miller, Walden University


The collection of urine for analysis is a procedure that occurs frequently in the emergency department (ED). If the urine specimen is obtained in a less than optimal manner by ED staff, then the test results may be inaccurate, and inappropriate antibiotic treatment may occur. Contamination of urine specimens is a known problem, but there is little written about the best methods to reduce the frequency of contamination. Lewin's theory of planned change was used to guide this project through the program development process in order to understand how to change the staff's method of education related to the collection of the urine specimen. The purpose of this project was to develop and validate a Urine Specimen Education (USE) program for the ED staff. An additional goal to be accomplished post-graduation will be to implement a pilot project to determine the impact of the validated USE program for the ED staff compared to standard teaching methods. The validation of the USE program was completed by having 13 expert members of the ED staff review the developed USE educational program. The experts completed a 7 question Likert-type scale survey. Descriptive analysis was used to evaluate the results of the survey and validate the education program. Results revealed that all the experts agreed that the program was easy to read, easy to follow and contained enough subject content. Most experts agreed that after completing the program they understood the importance of obtaining a properly provided urine specimen and could educate the patient on how to provide the urine specimen. Positive change will occur by reducing the number of contaminated urine specimens, reducing inappropriate antibiotic use, reducing care costs and reducing the development of antibiotic resistant organisms.