Urine Collection, 12- or 24-Hour Timed
Because hormones, proteins, and electrolytes are excreted in small, variable amounts in urine, specimens for measuring these substances must typically be collected over an extended period to yield quantities of diagnostic value. A 24-hour specimen is used most commonly because it provides an average excretion rate for substances eliminated during this period. Timed specimens may also be collected for shorter periods, such as 12 hours, depending on the specific information needed.
Equipment
Large collection bottle with a cap or stopper, or a commercial plastic container ▪ preservative, if necessary ▪ gloves ▪ bedpan, urinal, or bedside commode if the patient doesn’t have an indwelling catheter ▪ specimen collection hat ▪ graduated container, if intake and output are being measured ▪ ice-filled basin, if a refrigerator isn’t available ▪ specimen label ▪ laboratory request form and laboratory biohazard transport container ▪ patient-care reminders.
Implementation
Verify the doctor’s order for specimen collection.
Check with the laboratory to find out which preservatives may need to be added to the specimen or whether a dark collection bottle is required.
Gather the equipment and check the expiration date on the preservative container.
Confirm the patient’s identity using at least two patient identifiers according to your facility’s policy.4
Label the specimen container in the presence of the patient to prevent mislabeling.5 The label should include the patient’s name and identification number, the date, the start and end times of the collection, and your initials.
Explain the procedure to the patient and his family, as necessary, to enlist their cooperation and prevent accidental disposal of urine during the collection period. Emphasize that failure to collect even one specimen during the collection period invalidates the test and requires that it begin again.
Place the collection container at the bedside or in the bathroom. Place the container in an ice basin, as indicated. Replace the ice as needed. Explain that urine is to be kept and stored in the same collection container during the 12- or 24-hour period.
Explain dietary or drug restrictions, and make sure the patient understands and is willing to comply with them.
Place patient-care reminders over the patient’s bed, in his bathroom, and on the urinal or indwelling catheter collection bag. Include the date and the collection interval.
Instruct the patient to save all urine during the collection period, to notify you after each voiding, and to avoid contaminating the urine with stool or toilet tissue.
If the patient is using the bathroom toilet, place a specimen collection hat in the toilet bowl to collect and measure urine.
If possible, instruct the patient to drink two to four 8-oz (480 to 960 mL) glasses of water about 30 minutes before collection begins. After 30 minutes, tell him to void. Measure the amount of urine if output is being recorded. Note this time as the beginning time for the collection.
Perform hand hygiene and put on gloves1,2,3 to discard this specimen so the patient starts the collection period with an empty bladder.
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