Impact of Early Urine Specimen Collection on Emergency Department Time to Disposition: A Randomized Controlled Trial

BackgroundDiagnostic testing in the ED increases the length of stay (LOS). Urinalysis testing is highlighted specifically as a source of delays. We aim to determine whether a triage-initiated urine specimen collection process decreases ED time to disposition (TTD) in ambulatory patients with abdomin...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2020-09, Vol.12 (9), p.e10495-e10495
Main Authors: Bahl, Amit, Jamali, Ameen M, Ramesh, Gautam
Format: Article
Language:English
Subjects:
Abdomen
Age
Blood pressure
Blood tests
Clinical outcomes
Emergency medical care
Emergency Medicine
Heart rate
Medical records
Pain
Patients
Quality Improvement
Urinalysis
Urine
Variables
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Summary:BackgroundDiagnostic testing in the ED increases the length of stay (LOS). Urinalysis testing is highlighted specifically as a source of delays. We aim to determine whether a triage-initiated urine specimen collection process decreases ED time to disposition (TTD) in ambulatory patients with abdominal pain.MethodsThis prospective, randomized controlled study was implemented at a Suburban Level One trauma ED with greater than 120,000 annual visits. A convenience sample of patients was recruited. Adult, non-ambulance patients presenting with abdominal pain were eligible. Participants were randomized into experimental and control groups. Patients in the control group provided a urine sample after physician evaluation, if ordered by the provider. Patients in the experimental group were prompted to provide a urine sample in the triage restrooms immediately after screening at the greeter desk. The UA sample was transported to the treatment area and sent to the laboratory after physician evaluation.ResultsA total of 125 control patients and 124 experimental patients were enrolled. Forty-two patients were excluded because they were unable to provide a urine sample. Patients who had a urinalysis ordered were included in statistical analysis. Final data set included 65 patients in the experimental group and 96 patients in the control group. No significant difference (p=0.5072) in disposition time between subjects in the experimental group (n=65, mean=5:17 [hours:min]) and subjects in the control group (n=96, mean=5:30) was found.ConclusionsThe triage protocol for urine specimen collection did not significantly reduce ED TTD. Further research in overcrowded EDs with long patient waiting room times may benefit from implementing a triage protocol for urine specimen collection.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.10495