Implementation of the American Urological Association's microhematuria guideline in primary care

Purpose of the Project: To increase proper evaluation of adults who present with microscopic hematuria by implementing the standardized use of the American Urological Association’s (AUA) microscopic hematuria guideline by primary care providers. Methodology: A primary care provider in Northern NJ implemented the AUA’s microhematuria guideline into his practice to evaluate patients who presented with microhematuria. A retrospective chart review was performed to assess the evaluation of the adult patients (n=15) who presented to the office prior to the intervention and a prospective chart review was performed to assess adult patients (n=15) with microhematuria who presented after the intervention. Results Age: pre-intervention M=69.53, SD=9.841, post-intervention: M=65.93, SD=14518. Gender: pre-intervention: 9 females (60%), 6 males (40%), post-intervention: 7 females (46.7%), 8 males (53.5%). Smoker: 19 (63.3%). Non-smoker: 11 (36.7%). Risk factors: pre-intervention: 15 (100%), post-intervention: 15 (100%). Blood (+) on dipstick: pre-intervention: 15 (100%), post-intervention 15 (100%). Blood on microUA (>3RBCs/HPF): Pre-intervention: 11 (73.3%), post-intervention: 13 (86.7%). Diagnosis of microhematuria: Pre-intervention: 11 (73.3%), post-intervention: 13 (86.7%). Appropriate evaluation according to AUA guideline: pre-intervention: 1 (6.7%), post-intervention: 17 (100%). Correct referral to urologist: Pre-intervention: 11 (73.3%), post-intervention: 15 (100%), Pearson Chi-Square: p=0.032, df=1. Implications for Practice: The data and statistical analysis reveal the utilization of the AUA microhematuria guideline enhances patient evaluations and referrals to urologists, which could lead to overall improved patient outcomes.