We are in the process of implementing a new contract for urine dipsticks
which involves laboratory control of QC and EQA for the first time. This
involves a move away from the "Multistix" style of reporting and so far
we have one hospital site using the new sticks with the only problems
coming from the Womens' hospital.
They were using the plusses associated with a urine protein
concentration of 300mg/dl as a contributory trigger to admission and
potential induction of labour in pre-eclampsia situations. That
particular level is not present as a reference point on the packaging of
the new strips (150 and 500 mg/dl) so the nurses and midwives are
wanting to stay with the previous sticks. They didn't spot the cut-off
issue when they came to the evaluation sessions and we did not
anticipate them using urine dipsticks as a diagnostic test. The meter
does not give readings between the concentrations on the packaging
either.
I have explained the potential folly of making decisions based on a
guestimate of urine protein concentration rather than protein/creatinine
ratio and am waiting for a decision.
It seems that about half of the UK sales go to Roche or other suppliers
with the same interpretation levels so others may have experienced the
same issues. I am looking for guidelines or protocols from hospitals
which already use this type of strips in the hope we can change to a
more scientifically based practice.
Thanks in anticipation.
Richard Stott
Principal Clinical Scientist
Doncaster & Bassetlaw Hospitals NHS Foundation trust.
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