URINE SPECIMENS ALLOW the lab to screen for urinary disorders and other problems, such as drug use. Usually, a specimen is requested during a physical exam, during hospitalization, or for a drug screening.
Collection tips
To collect a urine specimen, give the patient a urine container with a lid. Prepare a label that has the patient's information on it, including the medical record number, name, and birth date. Avoid incorrect labeling by labeling the specimen in front of the patient. Fill out the lab request form and attach it to the specimen according to your facility's policy. Perform hand hygiene and wear gloves when handling the specimen.
Explain to the patient that you need a urine specimen for the lab, and provide him with the container. If the patient is a child, instruct the parent and ask her to collect the specimen. If the patient is unable to hold the container over the toilet and urinate into it, give him a clean urinal or bedpan to use on the toilet or in bed.
A clean-catch midstream specimen is the best noninvasive method of collection. Catheterization or suprapubic bladder aspiration is sometimes used. These are very invasive procedures, however, and their use is restricted.
When collecting a clean-catch midstream specimen, proper patient instruction in cleaning the urinary meatus and surrounding tissue before collection is the secret to collecting an uncontaminated specimen. Tell your patient to start the stream and begin the collection in the middle of the stream.
Instruct the male patient to clean the tip of his penis with soap and water, then with disposable wipes or with cotton balls soaked in povidone-iodine solution or Chloroprep. Tell him to start the urine stream and, without stopping, begin the specimen collection by moving the container into the urine stream. For an uncircumcized male, remind him to retract the foreskin to clean the urinary meatus more effectively and to keep it retracted during voiding.
Instruct the female patient to clean her genital area with soap and water and then to sit far back on the toilet or to sit backward on the toilet. It may be easier for her to strip from the waist down in order to spread her legs far enough apart. With disposable wipes or cotton balls soaked in povidone-iodine solution or Chloroprep, instruct her to wipe first down one side, then down the other side, and finally down the middle of the labial folds, vulva, and urinary meatus. Stress the importance of wiping from front to back to avoid fecal contamination. Instruct the patient to begin voiding into the toilet and to keep the labial folds separated during the specimen collection. Tell her to start the stream and, without stopping, begin collecting the specimen in the middle of the stream by moving the specimen container into the stream.
Wear gloves to collect the container and put on the lid without touching the inside of the lid. If the outside of the container is soiled, clean it and wipe it dry. Wash your hands and instruct the patient to do the same.
Using a catheter
When collecting a specimen from an in-dwelling catheter, clamp the catheter at least 30 minutes before collecting the specimen to allow urine to collect in the bladder. Never take a specimen from the collection bag because it's considered contaminated. Clamp the tube just below the point where you'll be collecting the specimen. If the drainage tube has a built-in sampling port, put on gloves and wipe the sampling port with alcohol. At a 90-degree angle, insert a needle with a large syringe, depending on how much urine is required for the specific test. Collect the specimen and unclamp the tubing. Place the specimen in the appropriate container, label it, and send it to the lab immediately.
Regardless of the type of urine specimen, record the time of collection, when it was sent to the lab, the method of collection, and the test ordered. Also document odor, color, and any unusual characteristics.
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