LAKE REGIONAL HOSPITAL
URINALYSIS
Fisher UriSystem Urinalysis System
Principle:
Urines are screened physically, chemically, and microscopically for two general purposes:
1. The detection and diagnosis of renal or urinary tract disease.
2. The detection of metabolic or systemic diseases not directly related to the kidney.
The Fisher Urisystem Urinalysis System provides accurate, reliable clinical information which can be used for efficient patient diagnosis and disease management. This is accomplished by the reduction of subjectivity through implementation of standardized procedure factors. Those factors which are standardized with the Urisystem include:
1. Standardized volume of urine examined (12 mls).
2. Standardized time and force of centrifugation (5 minutes at 450 RCF).
3. Standardized concentration factor of sediment (consistently 0.4 ml of sediment).
4. Standardized volume of sediment in the Urisystem Decislide (14 µl uniformed depth).
Standardization allows for the accuracy, sensitivity and precision required for reliable and meaningful urine microscopic results.
Specimen Requirements:
1. A minimum of 12 mls of urine is required.
2. A first morning voided urine is the preferred specimen. Properly collected random urines are acceptable.
3. Specimen should be collected in a clean, dry, plastic sterile cup.
4. Specimen must be correctly labeled.
5. If possible, examine the urine within two hours after voiding. If a delay in analysis is unavoidable, the urine may be refrigerated (2-8° C) for up to 48 hours.
Reagents, Additional Equipment Required:
1. Centrifuge capable of 450 RCF.
2. Brightfield microscope with 10x ocular, 10x and 45x objectives.
3. Bayer Multistix 10 SG Reagent Strips-
Store at room temperature between 15-30° C. Use within 2 months after first opening the bottle. Do not use product (opened or unopened) after expiration date. Do not
store bottle in direct sunlight. On a daily basis, record lot number and expiration date on urinalysis log.
Note: DO NOT USE DISCOLORED OR DARKENED STRIPS
4. UriSystem tubes
5. UriSystem Decislides
Quality Control:
1. Quantimetrix “The Dipper” Urine Controls Level 1 and 2 for dipstick analysis:
Controls are ready-to-use liquid requiring no reconstitution or dilution. Store unopened UA Controls at 2-8° C for up to the expiration date. Once opened, vials of control are stable for 3 months refrigerated (2-8° C) or for 20 dipstick immersions, whichever comes first. Bacterial contamination produces an increase in turbidity and/or characteristic odor. Discard vial if evidence of microbial contamination is observed.
2. Dipstick controls are reviewed by the Lab Manager.
3. Urinalysis controls, Multistix stock, and misc. urinalysis supplies and reagents are reordered based on need by the Blood Bank Supervisor.
Procedure:
1. Urine specimen is collected and transported to the laboratory.
2. Perform the usual dipstick specific tests: specific gravity, pH and chemical analyses on the sample.
3. Centrifuge 12 mls (optimal) urine in the UriSystem Tube at 1800 rpm (450RCF) for 5 minutes.
4. Completely decant the tube(s) with a smooth quick tilting motion. Do not shake or disturb the surface tension that holds a precise volume of sediment in the tip of the tube.
5. If you wish to stain the sediment, add one drop of BD Sedi-Stain to the residue in the tip of the tube.
6. Mix the sediment well and deliver one drop to the Decislide.
Decislide Procedure:
1. Mix the urine sediment well and deliver one drop onto the scalloped area. Capillary action will uniformly distribute 14µl of sediment into the chamber.
2. Low Power Field Examination:
a. Examine at least 10 fields of the preparation under low power with reduced light.
b. Enumerate casts and epithelial cells using a reasonable range/LPF. Identify types of casts and cells on high power.
3. High Power Field Examination:
a. Examine at least 10 fields of the preparation under high power with increased light.
b. Enumerate RBCs, WBCs, transitional and renal tubular epithelial cells, and
yeast using reasonable range/HPF.
c. Evaluate remaining microscopic parameters per laboratory policy.
Results:
The technologist should review all results and control values before reporting. All critical values will be called immediately to the patient’s physician and documented in Meditech under “Results Called”.
Limitations:
The laboratory has no minimal volume requirements to perform a urinalysis. If a specimen received has less than 12 mls of urine, perform the microscopic and qualify the microscopic with a comment stating the test was performed unspun or on less than 12 mls of urine. If less than 12 mls, the testing is no longer standardized based on this urinalysis system.
References:
1. Fisherbrand UriSystem Product Insert, Bulletin No. 1314.
Prepared: _____________________ Supercedes:___________________
Reviewed:___________________
By:_____________________ Reviewed:___________________
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Adopted:______________________ Reviewed:___________________
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By:_____________________ Revised:_____________________
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