Genitourinary: Collecting a urine specimen

Urinalysis includes physical examination of the urine, testing of urine, and examination of the urine under a microscope.

It can be used to diagnose and monitor various conditions, including kidney disorders; urinary tract infections; and systemic diseases, such as diabetes.

Now, for the routine urinalysis, a random urine specimen is required, which means that urine can be collected any time during the day without any special measures.

When the client is suspected to have a UTI, or urinary tract infection, it’s important to do a clean catch specimen.

“Clean catch” refers to cleaning the perineum and the skin on the genitalia to clear away any microbes on the skin that could contaminate the urine sample.

The sample should be taken midstream, meaning it should be collected from the middle of the urine flow.

This way, the first and last portion of the urine that’s more likely to contain bacteria from skin are not collected.

A properly collected clean catch specimen will help make sure any bacteria found in the urine specimen came from inside the urinary tract.

Now, before we review the details of collecting a urine specimen, here are some common care tips.

Based on facility policies, a nursing assistant can collect a urine specimen under the supervision of and at the direction of a licensed nurse who will provide you with instructions.

Always confirm the client’s identity to make sure the procedure is performed on the right person. Make sure that the specimen container is labeled with the client’s name and room number, as well as the date and time the specimen was collected.

At all times, respect the client’s privacy and modesty by remembering to close the doors and window covers, and ensuring the client is properly covered.

Okay, now, when collecting a urine specimen, first, gather the supplies you’ll need, including: gloves, paper towels, a specimen container, a collection device, toilet tissue, and a biohazard transport bag.

You may also need a bedside commode, a urinal, or a bedpan. For a midstream urine specimen, you will also need sterile gloves and a “clean catch” kit.

Put on gloves and cover the bathroom counter with a paper towel. Open the specimen container and place the lid on the paper towel with the inside facing up.

If the client can use a regular toilet, place a clean collection device, or specimen “hat,” inside the toilet. For people who can’t use the toilet, a bedside commode, a bedpan, or a urinal can be used.

It’s important to remember that stool can alter the results, so ask the client if they need to have a bowel movement before collecting the urine.

Now, if a midstream urine specimen is required, open the “clean catch” kit. Provide the client with special cleansing wipes from the kit if they’re able to clean the perineum by themselves. Otherwise, assist as necessary.

Wrap the wipe around one hand. If the client is a biological female, use your other hand to separate the labia. Then, use the wipe to wipe downwards from the top of the vulva and towards the anus.

If the client is a circumcised biological male, start by placing the wipe on the tip of the penis, while in an uncircumcised biological male, first retract the foreskin by gently pushing the skin downwards towards the base of the penis. Wash downwards towards the base of the penis in a circular motion.

Now, give the client time to urinate and assist as necessary. Remind them not to throw toilet tissue into the collection device, the bedside commode, the bedpan, or the urinal because this can alter the results.

If a midstream urine specimen is required, remind them to start the flow of urine, then stop it, and then restart it. The sample should be collected from the restarted flow.

In addition, when collecting a midstream specimen, biological females should keep the labia separated and uncircumcised biological males should keep the foreskin retracted.

Okay, now, for most clients, you can leave the room until they finish. Be sure that the call light is close to the client.

Remember to remove the gloves when you leave, dispose of them safely, and put on a new pair when you come back. Don’t forget to knock before entering.

Provide tissue paper, a moist cloth, or pre-moistened wipes if they are able to clean themselves; otherwise, you should assist in perineal care.

Also, assist the client with handwashing as necessary. If the client used the toilet or a bedside commode, help them return to bed. Take the collection device from the bedside commode to the bathroom.

If the client used a bedpan or a urinal, place the cover on and take them to the bathroom. Note the general quality, the amount, the color, and the odor of the urine. You may also be asked to measure the urine.

Now, to collect the urine specimen, raise the toilet seat and, while holding the specimen container over the toilet, pour about 90-120 mL of urine from the collection device, the bedpan, or the urinal into the container.

The container should be about three-quarters full with urine. Afterwards, empty the rest of the urine into the toilet. Close the specimen container tightly and place it back on the paper towel on the bathroom counter.

Be careful not to touch the inside of the lid or the container, especially if when collecting a midstream urine specimen. Now, dispose of one glove and use the ungloved hand to hold the biohazard transport bag.

Then, with your gloved hand, put the specimen container into the bag. Make sure not to touch the outside of the transport bag with the glove.