Pilot Test - UT

Appendix MM3

URINE TRANSPORT SURVEY

Please read through each survey question with the following elements in mind—

1. Consistency: Question made sense, logical possible responses.

2. Navigation: Easy to move through survey, any technical difficulties.

3. Text: Easy to read.

4. Other: Comments and/or suggestions for how to improve the question (e.g., there was not an answer that fit my laboratory, too few or too many responses).

• If you have no comments on the question, please write “no comment” in the “Other” box.

• If there are more questions fields on the form than you answered, disregard them.

• Keep track of how many minutes it takes you to complete the survey (not the collection form).

Name: ________________________________________________________________

Question	Elements		Specific Observations
21 Does your laboratory perform urine cultures? Yes/No
3 Do you refrigerate or use a chemical preservative if urines cannot be delivered within two hours? Yes/No
Other		Should there be 48 hour time limit after collection for refrigerated or preserved specimens?
What is it? Refrigeration Boric Acid Other
Consistency		Sounds like an either/or answer instead of yes/no.
Other		Specimens collected in the hospital are refrigerated. Specimens from urgent care facilities or Doctor’s offices are in transport tubes.
Do you require females collecting a midstream urine to clean their genital area prior to collection? Yes/No
Other		It is requested at least
Do you require males collecting a midstream urine to clean their penis prior to retracting the foreskin? Yes/No
Other		We just ask men to clean the head of the penis
What type of specimen do you prefer for newborns and children? Diaper Suprapubic aspirate Other
Other		-Our physicians very seldom do suprapubic aspirates but that would be the preferred specimen -The question re: What type of specimen do you prefer for newborns & children…I would choose “other” & fill in the text box with single catheterization. It won’t recognize the answer in the textbox. It wants me to choose one of the 2 options, but they don’t fit our laboratory. I just chose the one closer to what we do. -Would like a not applicable response because we do not do pediatrics. That’s done at a sister pediatric hospital (Lebonheur).
Do you know your percent of contamination of urine cultures? Yes/No
Other		-Our lab has a UF1000 Urine Particle Analyzer (AUWI). Cultures are only setup if a urine is flagged based on preset criteria. Our criteria is – Trace bacteria and/or >15 ubc’s/HPF. The instrument measures cellsperal and converts to cells/HPF, also flags presence of yeast. -Contamination rates – including outpatient or just facility? -not done at this time
If yes, what is it?
Do you know your positivity rate for your urine cultures? Yes/No
Consistency		Define positivity rate
Other		-The percent of positive cultures, as well as the percent contaminated is affected by the use of the UF100. Since we only setup cultures on urines that are flagged, we have very few negative ones. We do seem to have an increased number of contaminated cultures. -not tracked

How many minutes did it take you to complete the Current Practice survey (not the collection form)? _5 mins, 3 mins, 5 mins, 10 mins, skipped___

OVERALL SURVEY EVALUATION	Strongly Disagree	Disagree	Neutral		Agree	Strongly Agree
(Place an “X” to indicate your level of agreement for each statement below).	1	2	3		4	5
12. The survey questions are easy to understand.					1	4
13. I was always able to find an appropriate answer to choose.		2			3
14. The answer choices are clearly written.			1		1	3
15. There were not enough choices of answers.		1	1		2	1
16. I always found the answer that fit the circumstances in my laboratory.		2	1		2
17. Overall, the length of the survey was… (circle your answer)
too short	Appropriate (5)			too long
18. What did you like best about the survey (strengths, weaknesses)? It was easy to understand and get right to the point Short & direct
19. Additional thoughts/comments: I think I would also want to know if labs reject specimens that do not meet the criteria or if they attach a comment to the result saying the quality of the specimen may have been compromised by delay in transport. Questions -> easy to read text & easy to understand as well as navigate.

1 The first survey question is the “name” field.

2