MP66-01 HEMATURIA COMMUNICATION

Abstract

INTRODUCTION AND OBJECTIVE: Gross hematuria can be a challenge to describe for non-urologic health care providers. Tools to aid in accuracy of communication are lacking and not commonly incorporated in healthcare systems. Our aim is to determine the current status of hematuria communication and assess the ability to improve consistency in communication by using a color picture guide and specific assessment prompting. METHODS: We prospectively performed a single-institution, hospital wide-assessment including all inpatient floor nurses. A 15-item questionnaire was distributed electronically during a 3 week completion period. To evaluate hematuria communication, participants were shown an image of indwelling catheter tubing with gross blood in the urine. In 2 sequential pages, participants were asked to describe the same hematuria image using 1) currently established electronic medical record selection choices, then 2) using a newly devised color reference guide with specific prompting to evaluate clarity and presence of blood clots. Comparisons were made between assessments to evaluate the number of unique responses and rate of documenting clarity and clots. RESULTS: A total of 311 nurses participated in the survey (response rate of 21%) from varied health care settings including the intensive care unit (32%), medical floor (22%), surgical floor (18%), Urology floor (5%), or other (23%). Although the majority of nurses previously managed a patient with active hematuria (87%), 35% believed the urine in the catheter bag was most informative when describing patients with hematuria. The number of unique responses significantly decreased when using a color reference guide compared to current hospital practice (n=9 vs n=37, respectively). All nurses commented on clots (100% vs 1%) and clarity (100% vs 87%) after specific prompting compared to lower rates for current practices. Majority of nurses described the color reference guide as useful (n=287, 97%) and would utilize the tool in current practice if readily available (n=291, 98%). CONCLUSIONS: A newly devised hematuria color guide and prompting assessment significantly reduced variations in hematuria descriptions from health care providers. Nearly all surveyed nursing personnel would prefer to utilize such methodology when describing patients with hematuria. Prospective implementation to assess impact is warranted to further evaluate the potential benefit with hematuria communication. Source of Funding: N/A