Nursing Procedure 8.1
- Collecting a Midstream Urine Specimen
Obtains urine specimen using aseptic technique for microbiologic analysis.
Nursing Procedure 8.1
Obtains urine specimen using aseptic technique for microbiologic analysis.
Assessment should focus on the following:
Nursing diagnoses may include the following:
Outcome Identification and Planning
Sample desired outcomes include the following:
Special Considerations in Planning and Implementation
Midstream urine collection is frequently performed by the client, so instructions must be clear to obtain reliable laboratory results. Perhaps the most frequent error the client commits is poor cleaning technique. Be certain women understand to cleanse from the front to the back of the perineum, and men from the tip of the penis downward. If possible, a specimen should be obtained on first voiding in the morning.
Parental or staff supervision and assistance should be provided for young children during the procedure to reduce specimen contamination.
This procedure may be delegated to unlicensed personnel or to the client or a family member. Emphasize the importance of procedural accuracy.
| Action | Rationale | |
|---|---|---|
| 1 | Perform hand hygiene. | Reduces microorganism transfer |
| 2 | Explain procedure to client. | Reduces anxiety; promotes cooperation |
| 3 | Determine if client is allergic to iodine-based antiseptics and use alternative, if indicated. | Avoids allergic reactions |
| 4 | Provide privacy. | Decreases embarrassment |
| 5 | Don gloves. | Prevents contamination of hands; reduces risk of infection transmission |
| 6 | Wash perineal area with soap and water, rinse, and pat dry. | Reduces microorganisms in perineal area |
| 7 | Cleanse meatus with antiseptic solution in same manner as for catheterization in males (see Nursing Procedure 8.5, Steps 15–17) and females (see Nursing Procedure 8.6, Steps 20 and 21). | Reduces microorganisms at urethral opening |
| 8 | Ask client to begin voiding into bedpan, urinal, bedside commode, or toilet. | Flushes organisms from urethral opening |
| 9 | After stream of urine begins to flow, place specimen collection container in place to obtain 30 mL of urine. | Collects urine at point at which urine is least contaminated |
| 10 | Remove and cap container before client stops voiding. | Prevents end-stream organisms from dripping into container |
| 11 | Allow client to complete voiding using bedpan, urinal, bedside commode, or toilet. | Decreases retention of urine and additional risk for infection |
| 12 | Dry perineum or wash perineal area again if stain-producing antiseptic was used. | Removes antiseptic solution; promotes general comfort |
| 13 | Label specimen container with date, time, and client identification information. | Notes time and date of collection; ensures that specimen |
| 14 | Fill out agency requisition form for specimen. | Facilitates proper logging and charging in lab |
| 15 | Send specimen to lab immediately. | Avoids sending old specimen in which urine constituents may have changed |
| 16 | Discard equipment appropriately. | Reduces spread of infection |
| 17 | Remove and discard gloves and perform hand hygiene. | Reduces microorganism transfer |
Were desired outcomes achieved? Examples of evaluation include:
