Roswell, NM - Lovelace Regional Hospital changed the labeling guidelines for clean catch urine samples to halt inaccurate reporting of the most hated lab specimen ever, Director of Laboratory Services Erin Colico announced Friday.
Erin called this policy change the single most successful laboratory initiative in the history of urine methodology, where 98.7% of all clean catch urinary specimens failed to achieve national clean urine standards.
"The clean catch urine had become the laughing stock of lab samples. It's even worse than the third year medical student's cervical smear samples we get. We actually had one female ER urine specimen sent to us with multiple hairs we later identified as likely of male thigh origin," Jan told reporters.
"Once we realized nurses were never going to obtain appropriate samples from wheelchair-bound 92 year old non-English speaking hearing impaired demented women and doctors were never going to stop ordering them, we just decided to change the definition [of a clean catch urine]. All clean catch urine specimens are now automatically relabeled NOT CLEAN CATCH. There are no exceptions."
This wasn't always the case. Hospital officials spent fourteen years attending biweekly meetings with representatives from 27 different departments trying to solve the problem.
"I remember seven years ago when we had that four page exclusion criteria we had to fill out for every clean catch urine order," said Jesse Durang, the nurse who likes to tell stories about how things used to be.
With the introduction of computerized physician order entry (CPOE) in 2011, the job of risk stratifying patients as appropriate clean catch urine sample candidates was shifted to physicians. As expected physician compliance was only 2%. "Some physicians actually had the gall to give a verbal order for a nurse to fill out their CPOE urine sample protocol," Erin told reporters.
The physicians who did attempt to comply did not fair any better. "Most of the time we found physicians would speed click through the pop up boxes until they somehow managed to log themselves out and then give up or they would enter an order for an ANA instead of a urinalysis and they didn't even notice," Erin told reporters.
This proactive policy was met with praise from the Joint Commission "We are confident this policy will lead to more policies we can investigate and comment on."
"What if I told you demented people have no business giving us a clean catch urine sample."
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Erin called this policy change the single most successful laboratory initiative in the history of urine methodology, where 98.7% of all clean catch urinary specimens failed to achieve national clean urine standards.
"The clean catch urine had become the laughing stock of lab samples. It's even worse than the third year medical student's cervical smear samples we get. We actually had one female ER urine specimen sent to us with multiple hairs we later identified as likely of male thigh origin," Jan told reporters.
"Once we realized nurses were never going to obtain appropriate samples from wheelchair-bound 92 year old non-English speaking hearing impaired demented women and doctors were never going to stop ordering them, we just decided to change the definition [of a clean catch urine]. All clean catch urine specimens are now automatically relabeled NOT CLEAN CATCH. There are no exceptions."
This wasn't always the case. Hospital officials spent fourteen years attending biweekly meetings with representatives from 27 different departments trying to solve the problem.
"I remember seven years ago when we had that four page exclusion criteria we had to fill out for every clean catch urine order," said Jesse Durang, the nurse who likes to tell stories about how things used to be.
With the introduction of computerized physician order entry (CPOE) in 2011, the job of risk stratifying patients as appropriate clean catch urine sample candidates was shifted to physicians. As expected physician compliance was only 2%. "Some physicians actually had the gall to give a verbal order for a nurse to fill out their CPOE urine sample protocol," Erin told reporters. The physicians who did attempt to comply did not fair any better. "Most of the time we found physicians would speed click through the pop up boxes until they somehow managed to log themselves out and then give up or they would enter an order for an ANA instead of a urinalysis and they didn't even notice," Erin told reporters.
This proactive policy was met with praise from the Joint Commission "We are confident this policy will lead to more policies we can investigate and comment on."
"What if I told you demented people have no business giving us a clean catch urine sample."
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