Changes to Reflex Urine Culture Order

Using the results of urinalysis and urine microscopy as an indicator to perform culture (“reflex testing”) helps to improve the predictive value of urine culture and reduces unnecessary antibiotic treatment of bacteriuria.

On Tuesday, June 7th, several changes will be made to Epic order LAB8379, "Urinalysis with reflex culture".  The reflex culture continues to use the UA/C&S Kit (Stores #91900 for clean catch and #91901 for Foley catheters) as separate specimens are necessary for the UA/microscopy and culture.  Changes are as follows:

[1] The presence of white blood cells on microscopy has been added to the criteria used to determine if a culture is performed.
[2] The order is now a panel order rather than a smart group.
[3] Results display has changed. “Urinalysis with Reflex Culture and Microscopic Exam" orders will be displayed on the Lab tab and "Urine Culture, Reflex" will be displayed on the Micro tab.
[4] Collection workflow is updated. When LAB8379 has been ordered, the print hyperlink will print labels for both urinalysis and culture. Two specimens will then be collected, with one sent to specimen control and the other to Microbiology.

Further details regarding these changes are summarized in the processing instructions and in the Pathology Handbook.

Questions concerning testing can be directed to Bradley Ford, MD, PhD, Medical Director of Microbiology (ext. 6-2990, pager 8290) or Daniel Diekema, MD, (ext. 4-5626), Associate Hospital Epidemiologist.