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Ann Clin Biochem. 2018 Jan;55(1):77-83. doi: 10.1177/0004563216687589. Epub 2017 Feb 8.

Patient safety is not compromised by excluding microscopic examination of negative urine dipstick.

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University Department of Chemistry, Medical School University Hospital, Sestre Milosrdnice, Zagreb, Croatia.


Background Microscopic examination of samples with negative dipstick results is not necessary. The aims of this study were to: (i) assess the risk of excluding urine sediment examination with negative dipstick results and (ii) calculate time savings by introducing this process. Methods The risk analysis was done for samples with negative urine dipstick and positive sediment findings. Possible missed elements in sediment were defined as 21 errors. Time saving was calculated as average time for preparation and examination sediments. Data were presented as counts and percentages. Results Out of 2997 samples, negative dipstick results were reported for 926 (30.6%) samples, out of which, microscopic examinations were positive for 527 (17.6%) samples. 18/21 errors were detected, with missing <5 squamous epithelial cells (SQEC) and bacteria 1+ as the most frequent ones (22.7% and 22.4%, respectively). Errors with the intermediate risk for patients were missing to report: ≥5 SQEC, ≥5 transitional epithelial cells, ≥10 hyaline casts (11.9%, 0.21%, 0.32%, respectively). Errors associated with high risk were not detected. Estimated total time saving is more than 25 h/month. Conclusions Microscopic examination of urine samples with negative dipstick results can be excluded without risk for patients and can result with considerable time savings.


Laboratory optimization; patient safety; risk analysis; urinalysis

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