After eight years of hospitalist medicine and seeing inaccurate urinalysis results day after day, year after year, I’ve come to the conclusion that the straight cath vs clean catch debate is not a debate. If the urine didn’t come from a straight cath, I have zero faith in the accuracy of the results.
I know, I know. It takes time and effort for a nurse to perform the straight cath. It’s not comfortable for the patient to have a catheter inserted into their urethra. Plus, with bad nursing technique, one could introduce bacteria into the bladder when performing a straight cath urinalysis.
All that aside, if I’m a physician trying to make medical decisions based on accurate data, then having bad urine results that don’t represent the true picture is worse than not having any data at all. For example, here’s a classic case of what I have to deal with day in and day out when trying to make medical decisions on my patients. Below is a snap shot of three UA results obtained from Happy’s ER over two visits. I’m sure it’s the same no matter where you get your care in this country. The first two urinalysis results came from a clean catch sample of a horribly weak 89 year old female who presented with family complaints of “fever and weakness”, both days. Read more »
*This blog post was originally published at The Happy Hospitalist*