Physician Update

Changes to Urine Analysis with Reflex Culture 

Roles impacted: All providers who can order a UA 

Our current standard for reflexing urine analysis to culture is not in line with the best medical evidence, thus leading to additional cost of care.

After much review with INTEGRIS Infection Prevention medical staff and discussion at various medical staff quality committees, the following changes have been approved.

These changes are live and working appropriately in the lab production environment at all locations except Lakeside Women's Hospital.  

New requirements
  1. WBC > 10 with at least one or more of the following:
    •  Positive nitrate
    •  Positive leukocyte esterase
    •  Two or more positive bacteria

Previous requirements

  1. The urine macroscopy is positive for nitrate and/or leukocyte esterase
  2. The urine microscopy contains any of the following:
    •  Six or more WBC/HPF
    •  10 to 25 bacteria/HPF (few) or more and one or both of the following:
    ○  Six or more WBC/HPF
    ○  Positive leukocyte esterase
    •  Positive for nitrate and 10 to 25 bacteria/HPF (few) or more and one or both of the following:
    ○  Six or more WBC/HPF
    ○  Positive leukocyte esterase