A Visual Scale for Improving Communication When Describing Gross Hematuria

Area of Science:

• Urology
• Medical Communication
• Clinical Scale Development

Background:

• Gross hematuria (GH) management requires clear communication among healthcare providers.
• Ambiguous descriptions of GH can lead to suboptimal patient care and treatment adjustments.

Purpose of the Study:

• To develop and validate a standardized grading scale for gross hematuria.
• To enhance inter-provider communication and reduce variability in describing GH severity.

Main Methods:

• A 5-point scale for GH was created using a blood simulant and expert urologist consensus.
• The scale was validated by assessing inter-rater reliability among nurses, urologists, and advanced practice providers using visual aids.
• Fleiss' kappa analysis was employed to measure agreement.

Main Results:

• Initially, 28 different descriptors were used to describe GH samples.
• After implementing the 5-point GH scale, raters demonstrated near-perfect agreement (κ = 0.93, P < .001) in grading severity.
• The visual aid with the scale improved matching of samples to their corresponding severity.

Conclusions:

• A clinically useful 5-point grading scale for gross hematuria was successfully created and validated.
• The scale significantly improves communication and reduces ambiguous terminology among diverse healthcare providers.
• This tool standardizes the assessment of GH, leading to more consistent patient management.