Developing and testing a urine colour reference scale: a practice development project

摘要

Although it is a common reason for consulting a doctor, there is inconsistency in describing and discussing abnormally coloured urine. To produce a reliable visual urine colour rating scale that reflects and enables accurate reporting of varying degrees of concentrated urine and of macroscopic haematuria. A practice development project was undertaken in the Urology ward of an acute care private hospital. The project was patient focussed, multidisciplinary, actively engaged staff and was evolutionary. Initially a prototype chart was developed but was found to need redevelopment. Funding and ethics approval were obtained. Study 1 involved a second draft of the scale with three colours depicting hydration status and four depicting macroscopic haematuria, together with instructions for use. Study 2 demonstrated the need for and benefit of having a urine colour reference scale. Studies 3 and 4 demonstrated the very high intra-rater (r= 0-8175-0-9999) and inter-rater (r = 0-5886-0-9932) reliability of the scale. Following these studies it was decided to include a depiction of normal clear urine among the three colours depicting hydration status and the four depiction of macroscopic haematuria. A urine colour rating scale was developed and refined through repeated trials of efficacy and usability which may facilitate objective communication between patients, carers, nurses and doctors concerning the colour of urine (it also serves an educational function, giving prompts about the other factors likely to be of significance when management decisions are made). This scale can be used by healthcare workers and patients/carers when describing urine colour, especially during phone conversations to inform decisions concerning treatment.