Author: Eileen Shepherd is clinical editor at Nursing Times. Urine Specimen Collection. Patients should give informed consent for specimen collection and, as part of the process, the nurse should: All specimen containers must be transported in a self-sealing polythene bag with two compartments: one for the laboratory request form and one for the specimen (Brekle and Hartley, 2014). This article, the first in a four-part series, describes the general principles of specimen collection and how to collect a midstream specimen of urine Citation: Shepherd E (2017) Specimen collection 1: general principles and procedure for obtaining a midstream urine specimen. An MSU may also be obtained for near-patient urine testing and other tests, such as toxicology screening to identify causes of poisoning or drug overdose. The easiest and most common type of preservation is refrigeration of the urine specimen at 4-6 degrees Celsius within 2 hours of collection if the specimen is not able to be tested right away. Example: Begin collecting the 24-hour urine specimen by voiding at 7:00 am and discarding the urine. When a clean-catch urine specimen is required, follow the directions given under Urine for Culture in the Microbiology Specimens: Bacteriology and Mycobacteriology Specimens section. For healthcare personnel collecting specimens or working within 6 feet of patients suspected to be infected with SARS-CoV-2, maintain proper infection control and use recommended personal protective equipment (PPE), which includes an N95 or higher-level respirator (or facemask if a respirator is not available), eye protection, gloves, and a gown, when collecting specimens. 24hr urine in a PLAIN container. You can insert a sterile needle attached to a sterile syringe and withdraw a specimen from a port in the drainage tubing after swabbing with alcohol. Decide on a day to do the test when your child will be at home all day. Hospital environmental hygiene principles. Please refer to the Test Directory for specific tests. Urine specimens and children. While collecting the sample, it is important not to contaminate it or the container. If immediate transportation is not possible, it is important to consult local guidelines about storage of specimens. When collecting a 24-hour urine specimen:Where must the urine for a 24-hour specimen be stored? Random Urine Collection for Routine Urinalysis or Urine Culture All urine specimens should be collected as clean catch urine specimens, unless otherwise indicated. Patient should not eat seafood for a 48-hour period prior to start of collection. Citation: Shepherd E (2017) Specimen collection 1: general principles and procedure for obtaining a midstream urine specimen. Patients should wash and dry their hands before collecting an MSU; Dougherty and Lister (2015) also recommend that the urethral meatus is cleaned to further reduce the risk of contamination, although they acknowledge that the effectiveness of this intervention has been questioned. Inform the patient of the reason for specimen collection; Explain how long it will take for the results to be available and how the patient will receive them; Implications for care (Dougherty and Lister, 2015). Which of the following statements by the AP indicates that the specimen collection will have to be restarted? Measure and record this volume on the test request form and on the urine transport vial (see Pediatric Specimen Tubes below). A: Routine urinalysis R: Routine urinalysis can be done on a random clean voided specimen collected … Appropriate containers include plastic disposable cups or bags (for infants) with a capacity of 50 ml. The specimen needs to be sterile. Part 2 will cover sources of preanalytical artifact arising during urine collection, handling and transportation. Empty bladder completely on awakening in the morning and discard this urine specimen. These include adhering to: The equipment required will vary according to the specimen so nurses should consult local policies about which container to use. Which of the following results should indicate to the nurse the presence of a UTI? Good-practice principles for specimen collection are outlined in Box 1. https://www.hopkinsmedicine.org/.../24hour-urine-collection 3. Label the container with the patient's full name exactly as it appears on the test requisition. A: Have the patient urinate a small amount of urine before starting the collection. Collect all urine voided during the next 24 hours. Urine in the bladder is sterile and, in the absence of a UTI, it should not be contaminated with bacteria. Specimens should be sent to the laboratory as soon as possible after collection as a delay may adversely affect the results. For which of the following tests is a random sample voided into a clean cup appropriate? Patients who are able to do so should perform genital hygiene with soap and water, 0.9% sodium chloride solution or a disinfectant-free solution (Dougherty and Lister, 2015). Determining which urine collection method and container should be used depends on the type of laboratory test ordered. Ask the patient to wash their hands with soap and water and dry them, to reduce the risk of the specimen being contaminated. Urinary tract infection: signs and symptoms, Source: Health Protection Scotland (2013). This article, the first in a four-part series, explores the general principles of specimen collection and describes how to collect a midstream specimen of urine (MSU). Instructions to help patients with their test preparations or specimen collections. There are a couple of ways to collect the specimen. A nurse is teaching a patient about home collection of a stool specimen for fecal occult blood testing. This procedure should be undertaken only after approved training, supervised practice and competency assessment, and should be carried out in accordance with local policies and protocols. Think about this. A nurse caring for a group of patients in an ambulatory care clinic is collecting urine for several prescribed diagnostic tests. Disposable gloves and apron – additional personal protective equipment (gown, mask/respirator, visor) may be required depending on the specimen; Sterile container appropriate for the specimen (consult local policies); Biohazard (high-risk) label indicating the danger of infection (Brekle and Hartley, 2014) if the patient is known or suspected to have a Hazard Group 3 pathogen such as hepatitis B, hepatitis C or HIV (Health and Safety Executive, 2003). The collection of any tissue/fluid carries a risk to staff from splash or inoculation injury, so standard infection prevention and control precautions should be followed. Hold the urine cup a few inches (or a few centimeters) from the urethra and urinate until the cup is about half full. 4.4. How to Collect the 24-hour Urine Specimen. It is necessary when your health care provider wants to test your urine for bacteria, which may be causing an infection in your urinary tract. How to collect a clean urine specimen You have been given a container to collect a sample of urine from your child to test for a urinary tract infection. Do not collect the first urine produced in the morning (first void). A: Obtain specimens from three different stools. A nurse caring for a patient who has diabetes mellitus is having difficulty obtaining a capillary fingerstick blood sample for point-of-care blood glucose testing. An assistive personnel (AP) is collecting a 24-hour urine specimen from a patient. Visit our, Specimen collection 1: general principles and procedure for obtaining a midstream urine specimen, 100 years: Centenary of the nursing register, 2020: International Year of the Nurse and Midwife, Nursing Times Workforce Summit and Awards, Specimen collection 2: obtaining a catheter specimen of urine, Specimen collection 3: obtaining a faecal specimen from a patient with diarrhoea, Specimen collection 4: procedure for obtaining a sputum specimen, Specimen Collection: Microbiology and Virology, Urinary Tract Infection Surveillance for Use in Health and Social Care Facilities, Safe Working and the Prevention of Infection in Clinical Laboratories and Similar Facilities, The Code: Professional Standards of Practice and Behaviour for Nurses and Midwives, Wipe it out: One change to get it right – Essential Practice for Infection Prevention and Control, Newly qualified nurses: practical procedures, Winners of the Nursing Times Workforce Awards 2020 unveiled, Don’t miss your latest monthly issue of Nursing Times, Announcing our Student Nursing Times editors for 2020-21, How best to meet the complex needs of people with interstitial lung disease, Creating an electronic solution for early warning scores, New blended learning nursing degree offers real flexibility, Expert nurses share their knowledge of pressure ulcers in free-to-watch videos, CNOs lead seasonal tributes to nurses after year of Covid-19, Hancock reveals 2021-22 pay rise for nurses will be ‘unfortunately delayed’, University gets approval for ‘ground-breaking’ online nursing degree, Concern for nurses in Wales as Covid-19 cases rise at ‘alarming rate’, Investigation into NG tube errors calls for ‘standardised staff training’, Scotland announces appointment of new chief nursing officer, Survey reveals pressures faced by health visitors since Covid-19, Disruption from no-deal Brexit ‘last thing NHS needs’, PM warned, New resource for community nurses on responding to ‘long Covid’, Healthcare heroes, we need your voice now more than ever, This content is for health professionals only, This article has been double-blind peer reviewed, Appropriate to the patient’s clinical presentation, Collected in a way that minimises contamination, Collected in a way that reduces health and safety risk to all staff handling the specimen (including laboratory staff), Documented clearly using appropriate forms. Specimen pH should be between 4.5 and 8 and will stay in this range if kept refrigerated. Instructions Pregnancy Urine Test Urine Cytology Your health care provider has requested a urine specimen. Bring the specimen to the lab within 1 hour or collection or store refrigerated for up to 24 hours. Tagged with: Assessment skills: specimen collection Newly qualified nurses: practical procedures. A clean-catch urine specimen is a sample of urine. Specimen collection training . A nurse is caring for a patient who has a stage III pressure ulcer in the sacral area. Test name. Bacteria that colonise the distal urethra; Sterile container with a wide top to collect the urine, which can then be transferred into a specimen pot; Soap and water, 0.9% sodium chloride solution or a disinfectant-free solution for genital hygiene; Obtain informed consent and explain the procedure to optimise the quality of the specimen. Urine Specimens – an overview of collection methods, collection devices, specimen handling and transportation This Focus Topic is the first of a two part series on urine specimen collection. The 24-hour urine protein test checks the function of the kidneys and detects disease. A nurse is caring for a patient who has a suspected UTI. Specimens are an important part of a holistic assessment and can help to: Nurses frequently collect specimens including urine, stool and sputum. Check whether the patient needs any help. Collecting tissue/body fluids: precautions to take. A urine protein test measures the amount of protein in urine. Send the sample to the laboratory immediately (or within four hours) (Dougherty and Lister, 2015) or refer to organisational policy if storage is required. Principle. Using an incorrect container can affect the accuracy of results; for example, bacterial swabs contain a transport medium that is incompatible with viruses (Dougherty and Lister, 2015). Before you start, you should have been provided with a sterile container for the collection of the urine. Collect all urine for the next 24 hours so that the morning urine void on the second day is the final collection. Patient’s name, date of birth, ward/department and patient identification number or NHS number; Type of specimen and the site from which it was obtained; Diagnosis, history and reasons for request – for example, diarrhoea and vomiting, rash, pyrexia; History of antimicrobial drugs prescribed and administered if possible – specimens should be collected before antibiotics are prescribed as they may affect the result; Contact details of the health professional ordering the investigation (Dougherty and Lister, 2015; Brekle and Hartley, 2014). Show More about Collecting a Sterile Urine Specimen Residual urine, urine left in the bladder after voiding, can be measured at the time of catheterization. Nursing Times [online]; 113: 7, 45-47. 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