Download POCT (Point of Care Testing) Urine Pregnancy Testing in the

Bedside Urine Pregnancy Testing in the Emergency Department
Who may perform a Bedside Urine Pregnancy Test in the Emergency Department?
RN’s or LPN’s may perform a Bedside Urine Pregnancy Test when a urine pregnancy test is
ordered by the Emergency Physician.
Indications for performing a Bedside Urine Pregnancy Test in the Emergency Department:
 For diagnosis of pregnancy, as ordered by the Emergency Physician.
The following indications for ordering a Bedside Urine Pregnancy Test include:
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Missed period or sooner following unprotected intercourse.
Pregnancy suspected following failure of contraception method.
Women of childbearing age who are to undergo medical imaging (X-ray/CT) procedures.
Women of childbearing age who are about to undergo an invasive surgical procedure
(elective or emergent).
To assist in the diagnosis of ectopic pregnancy or other related conditions eg molar
pregnancy, miscarriage etc.
Women of childbearing age presenting to the Emergency Department with c/o abdominal
pain, pelvic pain, vaginal bleeding or vaginal discharge.
A physician’s order is required to carry out a Bedside Urine Pregnancy Test.
Childbearing age is defined as: 10 – 60 years of age.
Preparation of patient:
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Confidentiality must be maintained during the testing and when informing patient of
result. A private room is preferred when the physician discusses the result with the
patient.
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Urine sample can be obtained randomly at any time of the day. Use a sterile urine C&S
container to collect sample.
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Instruct patient where to place sample/who to give sample to so as to maintain
confidentiality and to prevent any possible confusion in results. RN/LPN receiving
sample will ensure sample is labeled accurately.
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Receiving RN/LPN to label the specimen container with the patient’s name, DOB, and
hospital identifying number.
N/Clinical Support/Nursing/Emerg/ER Protocols/Urine Preg test
Procedure for performing Bedside Urine Pregnancy Test:
After instructing patient regarding sample collection and providing necessary equipment, take
labeled sample to utility room between Cardio and ACR to perform the test.
Steps:
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Open the ICON 20 hCG urine pregnancy test kit.
Use dropper to siphon urine sample from specimen container.
Holding dropper vertically, add 3 drops into the sample (S) well.
Read the result in 3 – 5 minutes. Set Timer for 5 min and read result when alarm
sounds. Confirm negative results at 5 minutes.
Important: Any pinkish-purple line appearing after 5 minutes is invalid.
Interpretation of Results:
Positive Result: two pinkish purple lines, one each at the test (T)
position and at the control (C) position.
Negative Result: only one pinkish-purple line at the Control (C)
position.
Inconclusive or Invalid Results:
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A Control line should always appear. If there is no distinct pinkish-purple line visible at
the Control (C) position, the test is invalid.
 If there is any suspected procedural error by the person performing the test, the result is
invalid. Recommend repeating the test or obtaining a fresh urine sample and repeating
test.
 If there is any question as to the validity of the test result the urine sample tested in
Emergency should be sent to the laboratory for testing. Alternately a new sample,
preferably an early morning more concentrated sample, should be collected for retesting
Documentation of Results:
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The results will be interpreted by the RN/LPN who will then document the result as
positive or negative on the patient’s chart in the Nurse’s Notes section (included
date/time and signature).
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It is the responsibility of the attending physician to locate and review the result in the
patient’s chart or verbally obtain result from the nurse and to then provide the
information to the patient.
Referring Urine Specimen to the Laboratory for Testing
N/Clinical Support/Nursing/Emerg/ER Protocols/Urine Preg test
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Specimens that are very turbid should be referred to the laboratory for testing
Specimens that give an inconclusive or hard to interpret result should be referred to the
laboratory for testing
Quality Assurance
 Every 4 months the lab will provide an unknown QC sample to be processed as a patient
sample.
References: (Kraszewski, S. (2007). Procedure for pregnancy testing. Nursing Standard. 22,12,45-48), Icon 20 hCG Procedure Card.
N/Clinical Support/Nursing/Emerg/ER Protocols/Urine Preg test