Collection of a specimen of urine

Observing and testing a specimen of a person’s urine can tell us a great deal about their general health. Following routine urinalysis it may be necessary to obtain a specimen to send to the laboratory for further, more in-depth analysis. In doing so there are some general principles to be considered:

• Urine specimens should be tested as soon after collection as possible. Consequently if specimens cannot be transported to the laboratory and examined within two hours of collection they must be stored in an appropriate refrigeration unit at 4ºC. However, they should not be stored for longer than 24 hours otherwise any findings will be inaccurate.

• Assessment of the client’s physical and mental capacity prior to collecting a specimen of urine is essential in order to ensure that they can comply with the needs of the procedure, particularly if a mid-stream specimen (MSU) or a 24-hr collection is required. For an MSU, the client must urinate in the toilet or other receptacle, stop, pass urine into the specimen container or sterile receptacle, stop and then finish urinating as normal. If you wish to collect all the urine that the client passes in a 24-hr period (24-hr urine collection), special bottles containing preservatives and other chemicals are usually obtainable from the laboratory.

• For some investigations an early morning specimen may be required (EMU). It is therefore important to check the request form prior to undertaking the procedure, to ensure that the correct type of specimen is obtained.

Collecting a mid-stream specimen (MSU)

Procedure	Rationale
Explain the procedure to the client	To gain consent from the client and assess the amount of assistance they will require
Collect sterile specimen bottle, cleaning equipment and bedpan or urinal if required	To ensure that the specimen is not contaminated and to ensure that all equipment is to hand
Wash hands and apply gloves and plastic apron	To minimize risk of contamination
Wash client’s perineal area with soap and water and pat dry	To minimize micro-organisms contaminating sample
Clean meatus with antiseptic solution and allow to dry	To reduce risk of contamination
Ask client to commence voiding into bedpan/urinal/toilet	Flushes organisms from urethral opening
Place specimen bottle under stream of urine	To collect specimen of urine that is least likely to be contaminated
Remove specimen bottle and allow client to continue to empty bladder	Prevents end-of-stream organisms dropping into specimen bottle
For infants and small children, specifically designed containers are obtained which adhere to the perineum. Care should be taken to follow the manufacturer’s instructions when applying and removing these so that the child’s skin integrity is not broken	To facilitate collection of specimen. A child’s skin is very delicate and can easily be damaged
Remove gloves and plastic apron and wash hands	Minimizes risk of cross-infection
Ensure specimen is correctly labelled, and placed in appropriate plastic bag for transportation accompanied by request form	To prevent misidentification. To minimize risk to others
Dispatch the specimen to the laboratory immediately	To ensure validity of test