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Protocol Management of Dysuria, Urinary Frequency, and Vaginal Discharge

SHELDON GREENFIELD, M.D.; GERALD FRIEDLAND, M.D.; SALLY SCIFERS, R.N.; ARTHUR RHODES, M.D.; W. L. BLACK, Sc.D.; and ANTHONY L. KOMAROFF, M.D.
[+] Article and Author Information

Grant support: contract HSM 110-73-335, Bureau of Health Services Research and Evaluation, Health Resources Administration, Public Health Service, Department of Health, Education, and Welfare.

▸Requests for reprints should be addressed to Sheldon Greenfield, M.D., Department of Preventive Medicine, UCLA School of Medicine, Los Angeles, CA 90024.


Los Angeles, California, Boston, Massachusetts, and Lexington, Massachusetts


Ann Intern Med. 1974;81(4):452-457. doi:10.7326/0003-4819-81-4-452
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A protocol to be administered by nurses for the management of dysuria, frequent urination, and vaginal discharge was validated. In a randomized, controlled trial, 146 women were seen by both nurse and physician and then assigned to either the nurse-protocol treatment plan or the physician treatment plan. The clinical data collected by the nurse showed no important differences from the physicians' data. The protocol recommended that 89% of the patients be sent home without seeing the physician. The physicians agreed with the protocol-recommended disposition in all but two cases. All patients with complications were appropriately referred to the physician. In follow-up, more than 95% of both groups reported symptomatic improvement, and repeat urine cultures were negative. We conclude that the protocol can be accurately administered, makes sound recommendations, is safe, and efficiently saves physician time.

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