A Comparrison of Two Emergency Departments

Abstract

<p>Urosepsis accounts for approximately 25% of all cases of sepsis in the developed world. The mortality from urosepsis is high and the financial burden is exorbitant. Research has established that a patient’s survivability from sepsis is inversely proportional to time to antibiotic administration. The initial care of patients with urosepsis often occurs in the chaotic setting of the Emergency Department and obtaining a urine specimen is a key element of patient care. The purpose of the project was to compare two emergency departments door-to-urine time with a focus on urine procurement technique. Urine procurement may occur by straight catheterization, Quik <strong>®</strong>catheterization, indwelling urinary catheterization, or mid stream clean catch collection. One department has access to Quik <strong>®</strong>catheterization technology that is unavailable to the other department. Exclusion criteria are patients already diagnosed with UTI and patients taking antibiotics on arrival to the emergency room. A retrospective chart review was conducted on 60 records. Data collected included gender, age, chief concern, method of urine procurement, door-to-urine collection time, door-to antibiotic administration time and urinalysis results. Results showed that catheterization was not always faster than midstream clean catch collection. There were an insufficient number of Quik <strong>®</strong>catheterizations performed during the time frame of the study to establish a link between the technology and expedited urine collection or antibiotic administration. The study does suggest that greater awareness and more research is needed concerning care of the uroseptic patient in the ED.</p>