Case Study

Digital urine testing proves ‘cleaner, faster and more accurate’ in GP trials

May 2021

Jo Cotton, Lead Nurse, Brunel Medical Practice

In January 2021, Clinical Design Technologies Ltd invited twenty healthcare providers across Primary and Secondary Care to become Innovation Reference Sites and sign up to a large-scale pilot for Urine Testing System™. All participants shared an interest in adopting and benefiting from a next generation, digital approach to point-of-care urine testing. As part of the pilot, sites were able to try Urine Testing System™ in return for participating in an impact audit* and providing user feedback on their experience.

One of our first of our participants to give feedback was Brunel Medical Practice, a primary care provider that operates across three GP practices in Devon. We spoke to Jo Cotton, Lead Nurse at Brunel Medical Practice to find out what she thought about digital testing with Urine Testing System™.

How were urine tests processed before you joined the pilot?

“We implemented a new protocol last year because we were just being inundated with urine samples. Following the change, we don’t sample anything unless it’s within our protocol, so we found that reduced our urine systems down but we’re still processing around six samples a day.

When using manual dip sticks, we’d find that we’d be waiting for the allotted time on the draining board, we’d then go into patients notes, into all the different aspects of urinalysis, leukocytes, nitrates, putting all those individual pieces of data in, whilst eyeballing what was going on. Occasionally we found that we had about three or four urines cooking on the draining board, and whilst we follow infection control measures and meticulously wipe down, it’s not an ideal or hygienic situation.”

What other pressures influenced your choice to move to digital urine testing?

“We are courier-dictated, so all samples need to be processed for when the courier picks up. We have a couple of pickups a day, so bearing in mind that all the urinalysis is done by the nurses in no allotted time, in that there’s no appointment time to do urinalysis, we were having to carry out tests ad hoc and put them into our EMIS system all before the courier collects.

For us it’s kind of an add in, a ‘squeeze’ in even, as we have to fit them in between patients. We would go out in a 10-minute window to check for samples that had been dropped off and run and urine tests. Sometimes you could find that you have one or two, or you could have four or five. It just depends on who’s requesting what at the three sites. This can be quite stressful because you also know that your last courier check-up is at half past four. You could have nothing in the morning and then suddenly you get 10 urines to process, and you have still got patients to see or action.”

How are urine samples collected now that you are using Urine Testing System™?

“Now that we are using Urine Testing System™ patients come and collect a little kit from the porch. The kit contains the UTS tube, a collection cup and a slip of paper which they use to tell us what their symptoms are. They take the kit away and bring it back later in the bag provided. We have found that because they have everything they need and our instructions have been very clear, when they come back, their sample is in the pot, in the bag and it’s been decanted.

I haven’t had anybody with any problems with the collection cups and patients decanting their samples into the tubes. In fact, they probably find it more beneficial as they’ve been given what they need to take to the toilet and they think, well actually I can do this while I’m here. Also, the collection cup isn’t as frightening because the target’s so small. No one has come back to me with any concerns, and I think it’s probably more hygienic than before.”

How has moving to digital urine testing affected your practice?

“We’ve found that we are saving time processing urine samples. Now we just collect the urine samples, pop the cap on the top and put it straight in the digital analyser to run the test. By the time we turn around and prepare the next sample the result is there, we can process that result by copying it straight into the patient’s notes and actioning it. The time saving comes because the UTS Digital Analyser™ works away doing it for us making an accurate assumption, so that’s massive and we also don’t have open samples or wet strips on the draining board anymore. I would say very crudely that it’s probably shaving off five minutes per urine sample, every sample we have.”

Do you use the Boric Acid tablet-add system for samples being sent for microbiology analysis?

“We use the boric tablets and have not had any problems sending these to the laboratory at Torbay. We just open up the top, put one of the tablets in, close it, lock it for lab, put one of the red dots on and label it up, it’s not been an issue.”

How have you found digital testing versus manual testing?

“Urine Testing System™ is great. I’m not particularly a computer whizz kid, so I would say that it was very intuitive to set up.

We have found that it’s cleaner, it’s more precise, it’s faster, it’s much more accurate now than it was before when we were using manual testing.

It gives a much more clinical picture of what that sample is than one of our dipstick tests. Reading a dipstick is open to individual interpretation about a sample’s results whereas if you use Urine Testing System™ it’s all there and it also does the bilirubin test which is something we don’t offer on a dipstick test.

With a standard dipstick there can be quite a few variables about how you are going to enter that information onto EMIS.  Urine Testing System™ shows you the clinical data, you can actually see it recorded in a uniform technique. It’s very precise, nothing is being missed. If it’s negative it’s there, it isn’t open to interpretation of well it isn’t there, therefore is it negative?

Before it was open to interpretation, as to who was putting what information into the clinical notes. You can only look back on the information that has been provided and it is quite variable. Being able to look back and see all the data is more professional and much more clinical.”

What would you say to a fellow clinician who was considering moving to a digital testing solution like Urine Testing System™?

“I just think that once you’ve used it you would really struggle to not have it in your life. It’s so simple, it’s so clean and it’s quick which is really important for us in a very busy clinic where we were looking at how can we make our urine system work more effectively. Urine Testing System™ works really effectively for us.

I think that often the biggest, stumbling block for any clinician doing anything new is the concern that it’s going to take an awful lot of time to implement when we just don’t have that time. But the reality is this really doesn’t take any additional time and it’s so labour saving once you’ve got it and running. It’s just intuitive, there’s not an awful lot that needs to be put in place for you to implement it. I think what was massive for us and what I would share with anybody, is that Urine Testing System™ really is worth implementing and it is a very simple quick win.”

*No patient data has/will be observed or collected as part of the pilot.

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