Howanitz P J, Saladino A J, Dale J C
Department of Pathology and Laboratory Medicine, University of California at Los Angeles Medical Center, 90095-1713, USA.
Arch Pathol Lab Med. 1997 Jul;121(7):667-72.
To explore preanalytic handling of urinalysis specimens.
The study was a College of American Pathologists Q-Probes study consisting of two parts. The first part was a questionnaire about participants' urinalysis practices. The second part required collection of information from four specific urinalysis specimens per shift on 30 consecutive days or from 200 urine specimens, whichever occurred first.
Three hundred forty-six small hospitals enrolled in the Small Hospital Q-Probes program.
Compliance with guidelines requiring nonrefrigeration and specimen measurement within 2 hours of collection, and identification of practices associated with better performance.
Almost 50,000 urinalysis specimens were analyzed. About 68% of the specimens were measured without prior refrigeration, 2.3% were refrigerated before, 17.9% were refrigerated after, and 4.5% were refrigerated before and after arrival in the laboratory. Aggregate analysis indicated that 11.2% of never-refrigerated specimens exceeded the recommended 2-hour time standard before analysis. For inpatients and outpatients, respectively, 64% and 77% of laboratories were able to meet the 2-hour goal 90% of the time. Improved performance was associated statistically with ordering urinalysis stat, an enforced policy of specimen rejection for delayed transport of inpatient specimens, and the listing of a collection time for outpatient specimens.
A large number of urinalysis specimens exceeded current quality guidelines for handling. Laboratories must monitor and improve preanalytic handling of urinalysis specimens.
探讨尿液分析标本的分析前处理。
本研究是美国病理学家学会Q-Probes研究，包括两个部分。第一部分是关于参与者尿液分析操作的问卷调查。第二部分要求在连续30天内每班收集4个特定尿液分析标本的信息，或收集200份尿液标本的信息，以先达到者为准。
346家参与小型医院Q-Probes项目的小型医院。
遵守要求不冷藏以及在采集后2小时内测量标本的指南情况，以及确定与更好表现相关的操作。
分析了近50,000份尿液分析标本。约68%的标本在未预先冷藏的情况下进行了测量，2.3%的标本在到达实验室前被冷藏，17.9%的标本在到达实验室后被冷藏，4.5%的标本在到达实验室前后均被冷藏。综合分析表明，11.2%从未冷藏的标本在分析前超过了建议的2小时时间标准。对于住院患者和门诊患者，分别有64%和77%的实验室能够在90%的时间内达到2小时的目标。表现的改善在统计学上与开具尿液分析急查单、对住院患者标本延迟运送实行标本拒收的强制政策以及列出门诊患者标本的采集时间有关。
大量尿液分析标本超出了当前的处理质量指南。实验室必须监测并改善尿液分析标本的分析前处理。
