Urine Specimen Collection
A random urine specimen is usually collected as part of the physical examination or at various times during hospitalization. This specimen permits laboratory screening for urinary and systemic disorders; it’s also used for drug screening. The clean-catch urine specimen, also called a clean-catch midstream specimen method, is commonly used in place of random specimen collection because it provides a virtually uncontaminated specimen without the need for catheterization. Obtaining a clean-catch midstream specimen also provides a specimen that more accurately indicates the constituents of the urine being produced by the body.
An indwelling urinary catheter specimen—obtained by aspiration with a syringe—requires sterile collection technique to prevent catheter contamination and urinary tract infection. This method is contraindicated after genitourinary surgery.
Equipment
For A Random Specimen
Bedpan, bedside commode, or urinal with cover, if necessary ▪ specimen collection hat (if using the bathroom toilet) ▪ gloves ▪ graduated container ▪ specimen container with lid ▪ specimen label ▪ laboratory request form and laboratory biohazard transport bag.
For A Clean-Catch Midstream Specimen
Basin ▪ soap and water ▪ towel and washcloth ▪ sterile gloves ▪ gloves ▪ commercial clean-catch kit, containing antiseptic towelettes and a sterile specimen container with lid and label ▪ laboratory request form and laboratory biohazard transport bag ▪ bedpan or bedside commode, if necessary ▪ Optional: graduated container, specimen collection hat (if using the bathroom toilet).
If a commercially prepared kit isn’t used, you’ll need gloves, three sterile 2″ × 2″ gauze pads or cotton balls, antiseptic solution, a sterile towel, a specimen label, and a sterile specimen container with lid.
For an Indwelling Catheter Specimen
Gloves ▪ antiseptic pad ▪ 3-mL or 20-mL syringe (depending on volume of urine required for ordered tests) ▪ tube clamp ▪ sterile or nonsterile specimen container with lid (depending on ordered test) ▪ specimen label ▪ laboratory request form and laboratory biohazard transport bag ▪ Optional: 21G or 22G 1½″ blunt-tipped needle.
Implementation
Verify the doctor’s order.
Confirm the patient’s identity using at least two patient identifiers according to your facility’s policy.4
Explain to the patient that you need a urine specimen for laboratory analysis.
Explain the procedure to the patient and family to promote cooperation, prevent accidental disposal of specimens, and ensure a virtually uncontaminated specimen. If possible, provide illustrations to emphasize the correct collection technique.
Assess the level of assistance required by the patient.
Provide privacy. Allow an ambulatory patient to collect the specimen in the bathroom. Place a specimen collection hat in the bathroom toilet bowl if output is being recorded. For patients with limited activity, use a bedside commode or bedpan.
Collecting A Random Specimen
Instruct the patient on bed rest to void into a clean bedpan or urinal; ask the ambulatory patient to void into either one or a specimen collection hat placed in the toilet in the bathroom.
Put on gloves. Then pour at least 120 mL of urine into the specimen container, and cap the container securely.
If the patient’s urine output must be measured and recorded, pour the remaining urine into the graduated container. Otherwise, discard the remaining urine. If you inadvertently spill urine on the outside of the container, clean and dry it to prevent cross-contamination.
Clean the graduated container and urinal, bedside commode, or bedpan, and return them to their proper storage area.
Collecting A Clean-Catch Midstream Specimen, Female
Tell the patient to remove all clothing from the waist down.
Have the patient clean the periurethral area (labial folds, vulva, and urinary meatus) with soap and water. If the patient requires assistance, put on gloves and assist the patient with cleaning the periurethral area. Then discard gloves and perform hand hygiene.1,2,3
If appropriate, assist the patient onto a bedpan or bedside commode or walk her to the bathroom. Instruct her to sit far back on the toilet seat or bedside commode and spread her legs.
Perform hand hygiene and, using sterile technique, prepare the commercial kit or create a sterile field. If assisting the patient, put on sterile gloves.1,2,3
If not using a commercial kit, pour the antiseptic over the sterile 2″ × 2″ gauze pads or cotton balls.
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