Triage Standing Orders:
Diagnostic Testing in Triage
URINE COLLECTION
Purpose:
To decrease delays by initiating the diagnostic testing for patients presenting
with complaints suggestive of the need for urine testing, while waiting for a
medical screening exam.
Policy:
A Registered Nurse in the Emergency Department Triage Area may initiate Urine
Specimen Collection and testing for appropriate patients using a Medical Standing
Order.
Order:
A Urinalysis should be obtained and sent for the following patients:
All patients presenting to triage with complaint of vomiting, diarrhea,
dehydration, abdominal pain, flank/back pain, dysuria, hematuria
All pediatric patients presenting to triage with complaints of fever. (Patients
over 3 years of age with solely respiratory complaints do not need urine specimen
in triage).
All patients with a history of endocrine or metabolic disorders, urological or
renal disease, trauma suggestive of abdominal injury, or ingestions/poisoning.
A Urine Pregnancy Test should be obtained and sent for the following patients:
Women of childbearing years with complaints of abdominal pain, possible pregnancy,
or gynecological complaints.
Women of childbearing years who are unsure about their pregnancy status and may
require an x-ray.
A Genprobe Urine Test should be obtained and sent for the following patients:
All men or women with suspected STD (i.e. History of unprotected intercourse and
vaginal/penile discharge)
Procedure:
All patients having a urine specimen collected in triage will be instructed in
obtaining a clean void specimen (CVS) and provided with the appropriate collection
kit.
Label specimen per protocol.
Enter lab request in meditech and send specimen to lab
Document on Patient Care Record that specimen was obtained and sent to lab.
(Due to the difficulty of obtaining clean void specimens on young children,
children under 5 years old, will have their urine specimens collected once assigned
to a room. Pediatric patients still wearing diapers, needing a urine specimen,
will require catheterization, which will not be done in Triage.)
Approved by:
Sandra Wozniak, MD
Chief of Emergency and Ambulatory Services
Lori Hempstead, RN
Director, Emergency Services