This article, the first in a four-part series , describes the general principles of specimen collection and how to collect a midstream specimen of urine. Citation: Shepherd E Specimen collection 1: general principles and procedure for obtaining a midstream urine specimen. Nursing Times [online]; 7, Obtaining a specimen involves the collection of tissue or fluids for laboratory analysis or near-patient testing, and may be the first step in determining a diagnosis and treatment Dougherty and Lister, The procedure used to collect a specimen must minimise the risk of introducing error and protect the health and safety of both the patient and the staff who handle the sample.
This article, the first in a four-part series, explores the general principles of specimen collection and describes how to collect a midstream specimen of urine MSU. Nurses frequently collect specimens including urine, stool and sputum. They may also perform venepuncture to collect blood samples and support patients through complex procedures to collect specimens, such as biopsies.
An accurate specimen collection technique is essential to reduce the risk of contamination, which can lead to inaccurate results and inappropriate treatment Brekle and Hartley, , and can result in a longer length of hospital stay Dougherty and Lister, Specimens must be collected at the right time, using the correct technique and equipment, and be delivered to the laboratory as quickly as possible Dougherty and Lister, Good-practice principles for specimen collection are outlined in Box 1.
Box 1. Specimen collection: good-practice principles. Box 2. Note: Any urine that is voided from the bladder during the eight-hour collection period should be pooled and refrigerated, so that a true 8-hour specimen is obtained. Midstream Clean Catch Specimen This is the preferred type of specimen for culture and sensitivity testing because of the reduced incidence of cellular and microbial contamination.
Patients are required to first cleanse the urethral area with a castile soap towelette. The patient should then void the first portion of the urine stream into the toilet. These first steps significantly reduce the opportunities for contaminants to enter into the urine stream.
The urine midstream is then collected into a clean container any excess urine should be voided into the toilet. This method of collection can be conducted at any time of day or night. Timed Collection Specimen Among the most commonly performed tests requiring timed specimens are those measuring creatinine, urine urea nitrogen, glucose, sodium, potassium, or analytes such as catecholamines and hydroxysteroids that are affected by diurnal variations.
A timed specimen is collected to measure the concentration of these substances in urine over a specified length of time, usually 8 or 24 hours. In this collection method, the bladder is emptied prior to beginning the timed collection. Then, for the duration of the designated time period, all urine is collected and pooled into a collection container, with the final collection taking place at the very end of that period. The specimen should be refrigerated during the collection period, unless otherwise requested by the physician.
Accurate timing is critical to the calculations that are conducted to determine analyte concentrations and ratios. Interpretations based on faulty calculations can result in improper diagnoses or medical treatment. Catheter Collection Specimen This assisted procedure is conducted when a patient is bedridden or cannot urinate independently.
The healthcare provider inserts a foley catheter into the bladder through the urethra to collect the urine specimen. Specimens may also be collected through an existing foley catheter.
Specimens may be collected directly from a foley into an evacuated tube or transferred from a syringe into a tube or cup. Suprapubic Aspiration Specimen This method is used when a bedridden patient cannot be catheterized or a sterile specimen is required. The urine specimen is collected by needle aspiration through the abdominal wall into the bladder. Pediatric Specimen For infants and small children, a special urine collection bag is adhered to the skin surrounding the urethral area.
Once the collection is completed, the urine is poured into a collection cup or transferred directly into an evacuated tube with a transfer straw. Urine collected from a diaper is not recommended for laboratory testing since contamination from the diaper material may affect test results. There are many different manufacturers of urine collection containers. Information on a specific product's uses, features and claims should be obtained from that device's manufacturer.
Urine Collection Containers cups for collection and transport Urine collection container cups come in a variety of shapes and sizes with lids that are either snap on or screw on.
To protect healthcare personnel from exposure to the specimen and protect the specimen from exposure to contaminants, leak-resistant cups should be utilized. Some urine transport cup closures have special access ports that allow closed-system transfer of urine directly from the collection device to the tube. In all of these cases, handling and transport of the specimens to laboratories for testing is important to ensure the best results.
Once a specimen is collected, the physician may do a visual check to test for clarity or color. Healthy urine is clear and the color of pale straw without any visible sediment.
Once the specimen is delivered to a laboratory, it will undergo thorough diagnostic testing. A dipstick test may be utilized initially. A thin plastic strip treated with different chemicals is dipped into your urine.
Each chemical on the stick reacts and changes a different color if levels such as acidity or pH, white blood cells, glucose, or protein are present or above normal. Finally, a microscopic urinalysis checks for particles or sediment too small to be seen. Your doctor will discuss the results with you once he or she has reviewed them. Main Street Edmore, MI Chestnut Street Breckenridge, MI Pickard Street Suite Mt.
Pleasant, MI View More.
0コメント