VANDERBILT UNIVERSTIY MEDICAL CENTER
POINT OF CARE TESTING
CLINITEK 50 URINALYSIS
PROCEDURE
Clinitek® 50 Urine Chemistry Analyzer is used for glucose, bilirubin, ketone,
specific gravity, occult blood, pH, protein, urobilinogen, nitrite, and
leukocytes testing.
The Point of Care Testing (POCT) program at Vanderbilt University Medical
Center (VUMC) is overseen and coordinated by the POCT Steering Committee
as chartered by the Medical Center Medical board. The POCT Steering
Committee administers the program with the primary goal of meeting clinical
needs in the most cost-efficient manner possible. In order to provide for both
regulatory compliance and appropriate utilization of POCT, any clinical area
wishing to perform POCT must be approved by the POCT Steering Committee
and must maintain acceptable performance according to criteria set forth in
Hospital Policy 20-23.
I.
PRINCIPLE:
A.
Instrument- Reagent test strips saturated with urine are blotted
and placed on the Clinitek 50 table. The table is pulled inside the
instrument where each test pad is measured for color and amount of light
reflected. An incandescent lamp inside the instrument illuminates a fixed
“read area” on the reagent test strip. Light reflected from the test strip
surface is detected by a photodiode pack, containing four (Red, Blue,
Green, and IR) filters. The reflected light is then converted into electrical
impulses, which are processed by the instrument’s microprocessor and
converted into clinically meaningful results shown on the display screen or
printed by the internal printer.
B.
Multistix 10 SG test strips- The reaction of Bayer Multistix 10 SG
test strips depends on color development as an indicator of the
concentration of the following test reactions.

The pH test reaction uses methyl red/bromthymol blue indicator
system, which provides pH readings from 5.0 - 8.5. The color of the
test pad changes from orange to green to blue in this range of pH.

The glucose test is based on a double sequential enzyme reaction,
which requires glucose oxidase, peroxidase, and potassium iodide. A
glucose specific enzyme, glucose oxidase, catalyzes the formation of
gluconic acid and H202 from the oxidation of glucose. The enzyme
peroxidase catalyzes the reaction of H202 with a potassium iodide
chromagen to oxidize the chromagen to colors ranging from green to
brown.
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VANDERBILT UNIVERSTIY MEDICAL CENTER
POINT OF CARE TESTING
CLINITEK 50 URINALYSIS
PROCEDURE

The protein reaction uses tetrabromophenol blue reagent buffered at
a pH of 3. This colorimetric method is based on a concept known as
the “protein error of indicators,” where the point of color change of
certain buffered pH indicators is different in the presence or absence
of protein. Colors range from yellow (negative) through yellow-green,
green, and blue-green, as positivity increases. The protein test pad is
more sensitive to albumin than globulins (such as gamma-globulin,
Bence Jones, hemoglobin, and mucoprotein), and a negative result
does not necessarily rule out the presence of these other proteins

The ketone reaction uses sodium nitroprusside reagent, which, in the
presence of acetoacetic acid produces a color change from buff-pink
(negative) to purple as ketone concentration increases. Acetone and
B-hydroxybutyric acid are not detected with this method.

The bilirubin reaction occurs when bilirubin reacts with diazonium salt
(2,4 dichloroaniline) to form a tan color.

Urobilinogen reaction is due to the reaction of urobilinogen with pdiethylaminobenzaldehyde, (in an acid medium), producing a pink-red
color.

Leukocyte Esterase reaction is due to derivatized pyrrole amino acid
ester and diazonium salt. Leukocytes of the granulocyte series
contain the enzyme, esterase, in their granules. This enzyme
catalyzes the hydrolysis of the amino acid ester to liberate the pyrrole
compound, in turn reacting with the diazonium salt, resulting in a
purple color.

Nitrite reaction occurs when Nirite reacts with p-arsanilic acid yielding
a diazonium compound which, in turn, couples with a quinolin reagent
to produce a uniform pink color. Pink spots or edges should not be
interpreted as positive.

The Specific Gravity test reaction is based on apparent pka change
of certain pretreated polyelectrolytes in relation to ionic concentration.
In the presence of an indicator, color ranges from deep blue-green in
urine of low ionic concentration through green and yellow-green in
urines by increasing ionic concentration. This reaction employs 2.8%
w/w bromthymol blue, 68.8% w/w/ poly (methylvinylethermaleicanhydride); 28.4% w/w/ sodium hydroxide.

Blood reaction is based on the peroxidase-like activity of hemoglobin,
which catalyzes the reaction of disopropylbenzene dihyolroperoxide
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VANDERBILT UNIVERSTIY MEDICAL CENTER
POINT OF CARE TESTING
CLINITEK 50 URINALYSIS
PROCEDURE
and uses 3, 3’5, 5’ -tetramethylbenzidine. Blood is detected as intact
red cells or as free hemoglobin, although the reagent pad is much
more sensitive to the latter. The reaction is based on the liberation of
oxygen from peroxide by the peroxidase-like activity of heme. In this
test a benzidine compound is oxidized to a colored product ranging
from orange to green to dark blue.
II.
PURPOSE:
Bayer Multistix 10 SG and other various Bayer reagent test strips are used as a
screening procedure to monitor carbohydrate metabolism, kidney and liver
function, acid-base balance and urinary tract functions. It is recommended that a
confirmation microscopic exam be performed on the original sample if any of
the following are positive:

Blood, Protein, Nitrite, Leukocyte
Further evaluation or tests may be performed on the original sample if the
following are positive:

Bilirubin, Ketones
III.
SCOPE OF PRACTICE:
Clinitek 50 urinalysis testing may be performed by VUMC RN’s, LPN’s, Patient
Care Partners/Technicians, Operating Room Technicians, and Nursing Externs
working in areas/units approved by the POCT Steering Committee to perform
point of care urinalysis testing. To maintain this privilege, testing must be
performed in accordance with VUMC hospital POCT policy. All staff performing
testing must attend POCT orientation, annual proficiency testing, and follow
established testing protocol.
IV.
SPECIMEN REQUIREMENT AND COLLECTION:
A. Conditions for Patient Preparation
 Follow Patient Preparation and Collection Procedure for Point of
Care Testing policy.
B. Specimen Type
 At least 12 ml of fresh, first morning urine recommended.
C. Handling Conditions
 Use Standard Precautions
 Collect urine in a clean, dry container
 Do not centrifuge
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VANDERBILT UNIVERSTIY MEDICAL CENTER
POINT OF CARE TESTING
CLINITEK 50 URINALYSIS
PROCEDURE



V.
Use of preservatives is not recommended.
Test urine immediately. Refrigerate if testing cannot be performed
within one hour of voiding and let it return to room temperature
before testing.
Urine with prolonged exposure to room temperature and light may
yield altered results for bilirubin, urobilinogen, pH, glucose, and
nitrite tests.
REAGENTS AND SUPPLIES:

Bayer Multistix 10 SG reagent test strips (based on dry weight at
time of impregnation)
Glucose:2.2% w/w glucose oxidase;1.0% w/w peroxidase; 8.1%
w/w potassium iodide; 69.8% w/w buffer; 18.9% w/w nonreactive
ingredients
Bilirubin: 0.4% w/w 2,4-dichloroaniline diaxonium salt; 37.3% w/w
buffer; 62.3% w/w nonreactive ingredients
Ketone: 7.1% w/w sodium nitro prusside; 92.9 % w/w buffer
Specific Gravity: 2.8% w/w bromthymol blue; 68.8% w/w poly
(methyl vinyl ether/maleic anhydride); 28.4%w/w sodium hydroxide
Blood: 6.8% w/w diisopropybenzene dihydroperoxide; 4.0% w/w
3,3’,5,-tetramethylbenzidine; 48.0% w/w buffer; 41.2% non-ractive
ingredients
pH: 0.2% w/w methyl red; 2.8% w/w bromthymol blue; 97.0% w/w
inactive ingredients
protein: 0.3% w/w tetrabromphenol blue; 97.3% w/w/ buffer; 2.4%
w/w nonreactive ingredients
Urobilinogen: 0.2% w/w p-diethylaminobenzaldehyde; 99.8% w/w
noreactive ingredients
Nitrite: 1.4% w/w/ p-arsanilic acid; 1.3% w/w 1,2,3,4tetrahydrobenzo(h)-quinolin-3-ol; 10.8% w/w buffer; 86.5% w/w
nonreactive ingredients.
Leukocytes: 0.4% w/w derivatized pyrrole amino acid ester; 0.2%
w/w diazonium salt; 40.9% w/w buffer; 58.8% w/w nonreactive
ingredients

BIO-RAD Control System - Urine control Level I and Level II : Human
erythrocytes, constituents of animal origin, chemicals, and preservatives.

Clinitek 50 Urine Chemistry Analyzer
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VANDERBILT UNIVERSTIY MEDICAL CENTER
POINT OF CARE TESTING
CLINITEK 50 URINALYSIS
PROCEDURE
VI.
STORAGE AND STABILITY:







VII.
Reagent strips must be stored in the original capped vial at room
temperature (below 85 degrees F/ 30 degrees C). Replace cap
immediately after removing test strip.
Opened reagent strips may be used until the printed expiration date on
the vial if quality control testing is acceptable.
BIO-RAD qUAntify control Levels 1 and 2 will be stable until the
manufacturer’s expiration date when unopened controls are stored at
2-8°C (36-46°F).
Vials of BIO-RAD qUAntify control Levels 1 and 2 once opened will be
stable for 31 days when stored tightly capped at 2-25°C (refrigerated or
room temperature)..
All reagent strips and BIO-RAD qUAntify control Levels 1 and 2 must
be labeled with staff initials and valid expiration date.
Do not freeze control solution.
Do not store reagent strips in direct sunlight.
CALIBRATION:
The operator performs no calibration procedure. The Clinitek 50 automatically
performs a series of internal checks before and after testing.
VIII.
QUALITY CONTROL (QC):
 A “Control” product is used to check the accuracy of the dipsticks,
and the technique of the staff member performing the test.
 After removing control solution from refrigerator allow 15 minutes to
reach room temperature before testing.
 BIO-RAD qUAntify control Levels 1 and 2 must be used to perform a
QC test every 24 hours for each vial of test strips in use.
 BIO-RAD qUAntify control Levels 1 and 2 and Multistix 10 SG test
strips may be obtained from Center Supply (materials distribution)
A Control Package Insert is included in each box of Control and must be
posted in the area where dipstick Control testing is performed. The Expected
Ranges using the Multistix 10 SG dipsticks and Level I and Level II Urine Control
on the Clinitek 50 must be recorded on the QC log.
Control Package Insert
Always replace the insert
when a new bottle of control
is received
Lot # on insert must match Lot # on
Control Solution bottles
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VANDERBILT UNIVERSTIY MEDICAL CENTER
POINT OF CARE TESTING
CLINITEK 50 URINALYSIS
PROCEDURE
**** CONTROLS, MULTISTIX 10 SG TEST STRIPs , AND THERMAL PAPER MAY BE
OBTAINED FROM YOUR SERVICE CENTER OR CENTRAL SUPPLY

Urine Control Solution:
BIO-RAD Control System
Urine Control Level I (NOVA # 36559)
and Level II (NOVA # 18143)

Printer Paper:
CLINITEK 50 THERMAL PAPER
(NOVA #30560)
(5 ROLLS/BOX)
A. Performing Quality Control Test
 Observe Standard Precautions!
1. Check the expiration date on the control bottle (—expires 31 days
after opening) and verify the lot # of the control chart matches the
lot # of the control solution.
2. Allow control solution to reach room temperature and Verify the
reagent strips are in-date for use.
3. Remove reagent strip and immediately recap the vial.
4. Shake control bottle gently, to mix and remove dropper cap.
5. Invert control bottle and apply control material directly across each
pad by gently squeezing the bottle, making sure not to touch tip of
bottle to test strip pads and each pad is wet.
6. Press one of the green  start buttons on the Clinitek 50
7. Turn test strip on edge to allow excess to drain on an absorbent
tissue, or paper towel.
8. Place the test strip on the Clinitek 50 table in the center slot
position WITHIN 10 SECONDS of pressing the green start button.
9. The Clinitek 50 will automatically pull the table inside to analyze.
10. Clean dispenser tips and replace cap.
11. Once the test is complete document results and verify all analytes
are within expected ranges – found on Control Package Insert.
IX.
CORRECTIVE ACTION:
**If control test is not within range listed on the Control Package Insert:
a. Check expiration dates on control bottle and urine reagent strips. If
supplies are "out of date", obtain new supplies. If supplies are "in
date", repeat test.
b. If control test is still out of range, replace control and retest.
c. If control test is still out of chart range, replace test strips and retest.
d. Indicate corrective action taken on QC log and record the specific
problem and action taken on POCT Problem log
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VANDERBILT UNIVERSTIY MEDICAL CENTER
POINT OF CARE TESTING
CLINITEK 50 URINALYSIS
PROCEDURE
e. If troubleshooting steps do not correct the unacceptable control test,
follow Clinitek Operator’s Manual troubleshooting steps. If problem is
not resolved, contact unit/area manager or POCT Support Center 35707 or 3-8416
X.
PERFORMING A PATIENT TEST:
1. Open the urine dipsticks vial and remove one test strip. Immediately
recap the vial.
2. Mix patient sample by gently swirling.
3. Dip the test strip into the urine specimen making sure to immerse and
saturate all of the test pads. Immediately remove test strip from urine.
4. Press the green  start button as the test strip is removed from urine.
At the same time Drag the test strip along its edge, across the top of
container.
5. Blot the test strip by touching the edge of strip to paper towel.
(YOU HAVE 10 SECONDS TO BLOT THE STRIP AND PLACE IT ON THE
TABLE)
6. Place the test strip on the table of the Clinitek 50 in the center slot
position. The Clinitek will automatically pull the strip holder inside.
The result printout is available in 60 seconds.
7. Wipe the strip holder with gauze or paper towel, to remove excess
urine.
8. Write the name or MR# of patient on printout and document patient
results. See XIII, for documentation requirements.
XI.
REPORTING RESULTS:
Test result names may be abbreviated as shown below. You must include the
units for each result where applicable, when reporting patient test results in
permanent medical record. The use of symbols (+ /-) are unacceptable when
reporting patient or QC results.
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VANDERBILT UNIVERSTIY MEDICAL CENTER
POINT OF CARE TESTING
CLINITEK 50 URINALYSIS
PROCEDURE
See the following chart for printed results:
TEST
ABBREVIATION
UNITS
Glucose
GLU
mg/dL
Bilirubin
BIL
Ketone
KET
Specific
Gravity
SG
pH
pH
Protein
PRO
mg/dL
Urobilinogen
URO
E.U./dL
Nitrite
NIT
Occult
Blood
BLO
Leukocytes
LEU
XII.
ABNORMAL
Negative
100
250
NEGATIVE
SMALL
NEGATIVE
TRACE
15
< = 1.005
1.010
1.015
5.0
5.5
6.0
NEGATIVE
TRACE
30
0.2
1.0
2.0
500
> = 1000
MODERATE
LARGE
40
> = 80
6.5
7.0
7.5
1.020
1.025
> = 1.030
8.0
8.5
> = 9.0
100
> = 300
4.0
> = 8.0
NEGATIVE
POSITIVE
NEGATIVE
TRACE-LYSED
TRACE-INTACT
NEGATIVE
TRACE
SMALL
SMALL
MODERATE
LARGE
MODERATE
LARGE
INITIAL CLINITEK 50 SETUP:


XIII.
mg/dL
NORMAL SYSTEM
See Clinitek 50 Operator’s Manual (User’s Guide)
Changing printer paper, clearing memory etc: Refer to Clinitek 50
setup for instructions.
DOCUMENTATION:
A.
The following quality control information must be recorded on the
provided log sheets:

Date and time of control testing

Testing staff initials

Reagent/supplies Lot #, altered Exp. Date, and acceptable
QC ranges obtained from the urine control package insert

Clinitek 50 serial number

Clinitek 50 Control results

Daily cleaning of Clinitek 50 table

Any Corrective Action
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VANDERBILT UNIVERSTIY MEDICAL CENTER
POINT OF CARE TESTING
CLINITEK 50 URINALYSIS
PROCEDURE

The following information must be recorded in the patient’s chart:
B.







XIV.
If QC is not performed because no patient testing was
performed, you must write NPT or no patient testing on QC
log for said dates.
Patient test results (including units of measurement where
applicable)
Multistix lot # and expiration date
Date and time of patient test
Testing staff ID
Clinitek 50 serial number
All Clinitek Instrument problems and resolutions must be recorded
on the provided problem log
Storage refrigeration temperatures must be verified daily and
recorded on provided temp logs.
QUALITY ASSESSMENT
The manager or designee has oversight of the following requirements:









All POCT performed in patient care areas has been approved by the
Diagnostic Laboratories and the State of Tennessee.
Testing is performed only by staff approved by the Diagnostic
Laboratories and the State of Tennessee.
All staff are trained prior to testing, and assessed for competency
annually.
Individuals responsible for staff training and /or compliance review,
(quality control and patient documentation); have attended appropriate
training sessions provided by the POCT Support Center.
Initial training records, current annual competency records and
“designated” trainer records must be accessible.
Notification to the POCT Support Center of any changes or transfer of
testing personnel.
Current testing procedures and accessible to all testing staff.
Quality control and maintenance procedures are performed,
documented and reviewed for compliance by the manager or designee
at least weekly, and are accessible for two years following review. Any
corrective action is noted, and filed with records.
Routine review of random patient medical records by manager or
designee to verify compliance with patient test result documentation as
described in testing procedures. Examples must be available for
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VANDERBILT UNIVERSTIY MEDICAL CENTER
POINT OF CARE TESTING
CLINITEK 50 URINALYSIS
PROCEDURE


inspections.
All testing supplies are stored and labeled according to instructions
found in individual testing procedures.
CAP proficiency testing, as required, is performed according to
accompanying instructions and results and requested information
returned to the POCT Support Center within specified time frame.
Diagnostic Laboratories POCT Support Center Provides:





Technical support
Training
Content of training materials and testing procedures
Validation and implementation of testing methodologies
Assistance with request for testing privileges
The POCT Steering Committee is chartered by the VUMC Medical Board
and has the authority to revoke testing privileges.
XV.
INSTRUMENT MAINTENANCE:
 Observe standard precautions.
A.
Daily Cleaning
The Clinitek 50 test strip table must be kept clean if the instrument is to
provide accurate test results and operate correctly. Wipe table with gauze
or paper towel after every dipstick test, to remove excess urine.
1. Remove table by pulling it straight out of the instrument.
2. Wet a cotton-tipped stick with distilled water and thoroughly scrub the
trough and surrounding areas. Then rinse area well.
3. Dry table well with soft cloth or lint free tissue.
4. Check the white bar for dust, marks, or scratches; if it is dirty wet a
cotton-tipped stick and gently wipe the bar. Allow bar to air dry and
check it again. If it is scratched or scuffed, or can’t be cleaned contact
the POCT Support Center at 3-5707 or 3-8416.
**DO NOT USE ANYTHING THAT WILL SCATCH THE WHITE BAR
**DO NOT USE SOLVENTS OF ANY KIND TO CLEAN THE BAR
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VANDERBILT UNIVERSTIY MEDICAL CENTER
POINT OF CARE TESTING
CLINITEK 50 URINALYSIS
PROCEDURE
B.
Daily Disinfecting the Table
1. Remove, clean, and dry table.
2. Fill a tall, narrow container with about 4 inches of Isopropyl Alcohol or
Household Bleach.
3. Put table into solution, making sure the white bar is above the liquid
level.
4. Soak the table for no longer than 10 minutes, and then rinse well with
water.
5. Dry table with a soft cloth or tissue and insert it back into the
instrument.
**DO NOT ALLOW SOLUTION TO COME INTO CONTACT WITH THE
WHITE BAR**
XVI.
LIMITATIONS:
1. Drugs that contain azo dyes (e.g. Pyridiium) nitrofurantoin (e. g.
Macrodantin), and riboflavin, cause abnormal urine color and may
affect the color development on the reagent pad resulting in both false
positve and negative results.
2. The pH of the urine can become alkaline on standing due to release of
C02 or production of ammonia by urea splitting bacteria. The pH of
highly alkaline urine can appear lower due to a “run-over” effect where
acid buffer from the protein reagent pad runs over the adjacent pH
pad. Highly pigmented urines may mask the color reaction.
3. False negatives at the trace glucose level can be seen when elevated
levels of ketone or ascorbic acid are present.
4. False positive proteins may be seen with highly buffered, alkaline
urines, exposure to quaternary ammonium compounds, or exposure to
skin cleansers containing chlorhexidine.
5. False positive ketone results can be seen in highly pigmented urine
specimens and in the presence of high levels of levodopa.
6. False negative bilirubin results may occur with old specimens due to
oxidation of bilirubin, and ascorbic acid levels > 25 mg/dL. Indican and
other pigmented drugs may interfere with test interpretation.
7. False positive urobilinogen results may occur with para-aminosalicylic
acid (a bacterial drug) and sulfonamides. False negatives results may
occur when formaldehyde is present. Highly pigmented urines may
mask the color reaction.
8. Strong oxidizing agents can cause false positive leukocyte results.
Falsely lowered reading may be caused by elevated: 1) glucose (
3000 mg/dL); 2) specific gravity; 3) protein; 4) various drugs including,
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VANDERBILT UNIVERSTIY MEDICAL CENTER
POINT OF CARE TESTING
CLINITEK 50 URINALYSIS
PROCEDURE
tetracycline, cephalothin, cephalexin and ascorbic acid.
Highly
pigmented urines, especially those containing azo dyes, may mask this
reaction.
9. False negative nitrites may occur with: 1) ascorbic acid levels > 25
mg/dL at low nitrite levels; 2) improper bladder incubation time (< 4
hours); 3) lack of dietary nitrate; 4) high urine specific gravity.
10. Highly buffered alkaline urines may cause low specific gravity
readings relative to other methods. Elevated specific gravity readings
may be obtained in the presence of moderate quantities (100 - 750
mg/dL) of protein.
11. False positive blood may occur with certain oxidizing contaminants
such as hypochlorite and microbial peroxidase. Elevated specific
gravity may reduce the reactivity of the test.
XVII. LINEARITY:
When the Clinitek 50 exceeds the dynamic readout range the following
results will be seen:
Glucose
Bilirubin
Ketone
Specific Gravity
pH
Protein
Urobilinogen
Nitrite
Blood
Leukocyte
SENSITIVITY
Glucose
Bilirubin
Ketone
Blood
Protein
Nitrite
Leukocytes
 1000
Large
 80
 1.030
 9.0
 300
 8.0
Positive
Large
Large
75 – 125 mg/dL
0.4 – 0.8 mg/dL
5 – 10 mg/dL
0.015 – 0.062 mg/dL
15 – 30 md/dL
0.06 – 0.1 mg/dL
5 – 15 cells/hpf in clinical urine
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VANDERBILT UNIVERSTIY MEDICAL CENTER
POINT OF CARE TESTING
CLINITEK 50 URINALYSIS
PROCEDURE
XVIII. PROCEDURAL NOTES:
1. Urine must be collected in a clean dry container free from any detergents,
or disinfectant residue since the oxidants contain in such cleaning agents
may cause the test areas on the urine test strips for blood and glucose to
indicate false positive results.
2. Do not touch the testing area with anything except urine or control
solution.
3. Do not use test strip if the testing areas are discolored
4. Do not cut or manipulate test strips.
5. If urine test strip screening is unavailable due to QC, supply or staffing
issues, perform visual urinalysis test method or send patient specimens to
the clinical laboratory for testing.
Differences Between the Human Eye and Instrumental Optics
There are inherent differences between the colors that are perceived by the
human eye and that are detected by any instrumental optical system. The
human eye is capable of detecting minute differences in shade and very
small areas of color; artificial optical systems are less sensitive to such small
changes. Conversely, instrumental optics is capable of detecting certain
colors that are masked by or blended with other colors to the human eye.
For this reason, exact agreement between visual results and instrumental
results might not be found. However, agreement is generally within one
visual color block or reported level and is equal to or better that the
agreement between two visual readers. Agreement of urine color is generally
within one step along the chromatic scale.
XIX.
SAFETY:
1. The Clinitek 50 operator should use personal protective equipment
(PPE) when performing urine dipstick testing.
2. OSHA and institution protocols for handling bio-hazardous materials
should be observed at all times.
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VANDERBILT UNIVERSTIY MEDICAL CENTER
POINT OF CARE TESTING
CLINITEK 50 URINALYSIS
PROCEDURE
XX.
REFERENCES:
1. Bayer Corporation Diagnostic Division, Elkhart, Indiana, Clinitek 50
User’s Guide, July 1996.
2. Siemens: MULTISTIX10SG Product Insert # AN30516F, Siemens
Healthcare Diagnostics Inc., Tarrytown, NY 10591-5097 USA. Rev.
08/08.
3. BIO-RAD: Control System product insert #02A-975. BIO-RAD Laboratories,
Clinical Diagnostics Group, 9500 Jeronimo Road, Irvine, California 92618.
Rev 8-2008.
4. VUMC Hematology- Urine Reagent strip Testing Procedure, 2002
5. VUMC POCT Support Center
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