Definition
Collecting a urine specimen is a fundamental nursing skill used for diagnostic testing, including urinalysis, culture and sensitivity, and drug screening.
It involves collection of a small sample of urine (30-60 mL) for detecting the presence and growth of microorganisms in sample.
Purposes
- To culture pathogenic microorganisms, present in the urine.
- To determine antibiotic sensitivity of the pathogens in the urine
Articles
- Sterile urine container
- Laboratory form
- Soap and water.
- Bed pan (for non-ambulatory patient).
Procedure
| NURSING ACTIONS | RATIONALE | |
| 1. | Before procedure Check the physician’s order and identify the patient. | Helps to understand purpose of procedure for the patient. |
| 2. | Assess the patient’s mobility status and activity tolerance to use the toilet facilities. | Determines the level of assistance required. |
| 3. | Explain procedure to patient including reasons for collecting specimen, and how the patient can collect an uncontaminated specimen (if the patient is able to). | Contaminated urine may result in false results. |
| 4. | During procedure Wash hands and don gloves, if nurse is to perform procedure. | |
| 5. | Provide privacy by closing curtains and/or door. | Privacy allows patient to relax and reduces embarrassment. |
| 6. | Instruct patient to cleanse the perineum. Female: Wash the urethral meatus and surrounding area with soap and water. Male: Hold the penis with one hand and cleanse the end of penis moving from center to outside using soap and water. For helpless patients: The nurse should provide hygienic perineal care. | |
| 7. | Assist bedridden patient on to bed pan. | |
| 8. | Instruct to open specimen container and place cap with inside sterile surface up and not to touch inside of container and lid. | Contaminated specimen will lead to inaccurate reporting of culture and sensitivity. |
| 9. | Instruct ambulatory patients to: Female: Sit on the toilet with legs separated. Male: Sit down to control splashing. | Prevents contamination of container from outside. |
| 10. | Instruct patient to direct the first and last part of the urine stream into the toilet or bedpan, collect the middle part of the stream into the sterile container (midstream sample). | Prevents contamination of the specimen with skin flora. |
| 11. | Replace cap securely on specimen container, cleanse any urine from external surface of container and place container in plastic bag or in the designated place. | Prevents transfer of microorganisms to others. |
| 12. | Remove bedpan (if applicable) and assist patient to a comfortable position. | Promotes relaxing environment. |
| 13. | Label specimen and send to laboratory with filled in requisition form. | Prevents inaccurate identification that could lead to errors in diagnosis and therapy. |
| 14. | After procedure Remove gloves and dispose in proper receptacle (if used for bedridden patient), and wash hands. | Reduces transmission of microorganisms. |
| 15. | Transport urine specimen to laboratory within 15 minutes or refrigerate immediately. | Bacteria grow quickly in urine and specimen should be analyzed immediately to obtain correct results. |
| 16. | Record the time of urine collection and any other observation in the nurses’ notes. | Documents implementation of physician’s order. |
Special Considerations
- Patients who are catheterized should have the specimen withdrawn using a sterile needle and syringe from the catheter’s sampling port. Clamp the collection tube for about 30 minutes before taking sample.
- Urine specimen must be transported to the laboratory promptly. If not cultured within 30 minutes of collection, urine must be refrigerated, and culture should be done within 24 hours.
About 30 minutes prior to collecting the specimen patient should be encouraged to drink fluids unless contraindicated.
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwer’s, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884.
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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