Assisting With Specimens
• Define the key terms and key abbreviations listed in this chapter.
• Explain why specimens are collected.
• Explain the rules for collecting specimens.
• Describe the different types of urine specimens.
• Perform the procedures described in this chapter.
• Explain how to promote PRIDE in the person, the family, and yourself.
Specimens (samples) are collected and tested to prevent, detect, and treat disease. Most specimens are tested in the laboratory. All specimens sent to the laboratory require requisition slips. The slip has the person’s identifying information and the test ordered. And the specimen container is labeled according to agency policy. Some tests are done at the bedside. When collecting specimens, follow the rules in Box 22-1.
See Promoting Safety and Comfort: Assisting With Specimens.
Urine Specimens
Urine specimens are collected for urine tests. Follow the rules in Box 22-1.
See Delegation Guidelines: Urine Specimens.
See Promoting Safety and Comfort: Urine Specimens.
The Random Urine Specimen
The random urine specimen is used for routine urinalysis (UA). No special measures are needed. It is collected any time during a 24-hour period. Many people can collect the specimen themselves. Weak and very ill persons need help.
See procedure: Collecting a Random Urine Specimen, p. 358.
Collecting a Random Urine Specimen
1. Follow Delegation Guidelines: Urine Specimens, p. 357. See Promoting Safety and Comfort:
3. Collect the following before going to the person’s room.
• Laboratory requisition slip
• Specimen container and lid
• Voiding device—bedpan and cover, urinal, commode, or specimen pan (Fig. 22-1)
• biohazard label (if needed)
4. Arrange collected items in the person’s bathroom.
6. Identify the person. Check the ID bracelet against the requisition slip. Also call the person by name.
7. Label the container in the person’s presence.
9. Collect a graduate to measure output.
11. Ask the person to void into the device. Remind him or her to put toilet tissue into the wastebasket or toilet. Toilet tissue is not put in the bedpan or specimen pan.
12. Take the voiding device to the bathroom.
13. Pour about 120 mL (milliliters) (4 oz [ounces]) into the specimen container.
14. Place the lid on the specimen container. Put the container in the plastic bag. Do not let the container touch the outside of the bag. Apply a biohazard label.
15. Measure urine if I&O are ordered. Include the specimen amount.
16. Empty, rinse, clean, disinfect, and dry equipment. Return equipment to its proper place.
17. Remove and discard the gloves. Practice hand hygiene. Put on clean gloves.
20. Provide for comfort. (See the inside of the front cover.)
21. Place the call light within reach.
22. Raise or lower bed rails. Follow the care plan.
24. Complete a safety check of the room. (See the inside of the front cover.)
26. Take the specimen and requisition slip to the laboratory or storage area. Wear gloves.
27. Remove and discard the gloves. Practice hand hygiene.
The Midstream Specimen
The midstream specimen is also called a clean-voided specimen or clean-catch specimen. The perineal area is cleaned before collecting the specimen. This reduces the number of microbes in the urethral area. The person starts to void into a device. Then the person stops the urine stream, and a sterile specimen container is positioned. The person voids into the container until the specimen is obtained.
Stopping the urine stream is hard for many people. You may need to position and hold the specimen container in place after the person starts to void (Fig. 22-2).
See Focus on Communication: The Midstream Specimen.
See procedure: Collecting a Midstream Specimen.
Collecting a Midstream Specimen 
1. Follow Delegation Guidelines: Urine Specimens, p. 357. See Promoting Safety and Comfort:
3. Collect the following before going to the person’s room.
• Laboratory requisition slip
• Midstream specimen kit—specimen container, label, towelettes, sterile gloves
• Sterile gloves if not part of the kit
6. Identify the person. Check the ID bracelet against the requisition slip. Also call the person by name.
• Voiding device—bedpan and cover, urinal, commode, or specimen pan if needed
• Supplies for perineal care (Chapter 16)
• Graduate to measure output
10. Provide perineal care (Chapter 16). (Wear gloves for this step. Practice hand hygiene after removing and discarding them.)
12. Put on the sterile gloves.
13. Open the packet of towelettes.
14. Open the sterile specimen container. Do not touch the inside of the container or lid. Set the lid down so the inside is up.
15. For a female—clean the perineal area with towelettes.
a. Spread the labia with your thumb and index finger. Use your non-dominant hand. (This hand is now contaminated. It must not touch anything sterile.)
b. Clean down the urethral area from front to back. Use a clean towelette for each stroke.
c. Keep the labia separated to collect the urine specimen (steps 17 through 20).
16. For a male—clean the penis with towelettes.
a. Hold the penis with your non-dominant hand. (This hand is now contaminated. It must not touch anything sterile.)
b. Clean the penis starting at the meatus. (Retract the foreskin if the male is uncircumcised.) Clean in a circular motion. Start at the center and work outward.
c. Keep holding the penis (and foreskin retracted in the uncircumcised male) until the specimen is collected (steps 17 through 20).
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