Hospital clinical practice around urinalysis is an important opportunity for antimicrobial stewardship improvement activities

Course Content

Hippocrates (430-377 BC) noted that the condition of urine could reflect health. Throughout history, people created charts of urine colour to help diagnose disease and by the 17th century, practitioners began tasting urine (yes, tasting,) to help diagnose diabetes; thankfully, urinalysis has become more sophisticated since those times.

Urinalysis remains one of the first tests done for diagnosis of disease, especially diseases that may remain essentially silent until they are advanced. The urinalysis is a simple and non-invasive test that provides valuable information. Clinicians rely on the urinalysis to make a presumptive diagnosis of urinary tract infection (UTI).

The information provided by urine in regard to health is somewhat more subtle and not so well-understood. It should be emphasized that urine information is of great importance in providing a profile of health, as well as of a disease.

Urine has been referred to as a mirror that reflects activities within the body. It has also been identified as presenting a biopsy of the kidney. It is the principal route of waste removal of products of metabolism from the body. It is the human body’s chief pathway of response to provide some sort of regulation of the heterogeneous intake of foods and liquids.

Urine is an amazingly complex entity that has much information of varied nature to contribute as a result of the measurement of many chemical and physical parameters. Urine can provide information relative to many body systems and organs, and its range of information extends much wider than just the kidney. The analysis of urine can provide information about the functions of the whole body as well as its many parts. Disorders of the kidney obviously modify the composition of the urine. But kidney disorders may also complicate many other body processes. Urine study may also reflect the situation when kidney function is normal, but other parts of the body are out of synchronization.

The objective of this study was to identify knowledge, perception and practice around urinalysis and ASB and to determine drivers of inappropriate urinalysis practice in an Australian hospital setting by undertaking a survey of nursing staff and a ward audit.

Learning Outcomes

In this session, you will:

• Explore the efficacy of routine urinalysis on admission
• Investigate over-diagnosis of urinary tract infection (UTI)
• Review over-treatment of asymptomatic bacteriuria (ASB)
• Understand current best practice in the diagnosis of symptoms of UTI