AUBF LAB

• Urine is the second most commonly used specimen for diagnostic testing, monitoring of disease status and detection of drugs
• Urine testing, using both automated and traditional manual methods, is growing rapidly
• Proper specimen collection ensures quality analytical testing
• Urine specimen


  May be collected in a variety of ways according to the type of specimen required, the collection site and patient type
• Ideal Specimen Container


  • Wide mouth –to facilitate collections from female patients
  • Wide, flat bottom – to prevent overturning
  • Clear material – to allow for determination of color and clarity
  • Recommended capacity – 50 mL (12 mL – for microscopic analysis, additional specimen for repeat analysis, and enough room for the specimen to be mixed by swirling the container
• Pediatric Urine Collection Container

  • Hypoallergenic skin adhesive
  • Area should be contamination-free
  • Attach over genital area avoiding the anus
• Specially designed containers


  • Sterile –for microbiology testing
  • Preservatives
  • Conical bottom tubes – for sediment analysis or Round bottoms for automated reagent strip testing
• Urine Collection for Males


  1. Cleanse the end of the penis first with soap towelette beginning at the urethral opening and working away from it

  2. If uncircumcised, the foreskin must be retracted first

  3. Repeat process twice using clean towelette

  4. Void the first portion of the urine into the toilet

  5. Collection should be done during midstream voiding

  6. Without touching the inside of container or lip of the cup with hands or any other part of the body
• Urine Collection for Females

  1. Stand in a squatting position over the toilet

  2. Cleanse by separating the folds of skin around the urinary opening using towelette

  3. Repeat process twice using clean towelette

  4. Void the first portion of the urine into the toilet

  5. Collection should be done during midstream voiding

  6. Without touching the inside of container or lip of the cup with hands or any other part of the body
• 24-Hour (Timed) Specimen Collection

  1. Provide the patient with written instructions, and explain the collection procedure

  2. Provide the patient with the proper collection container and preservative

  3. Day 1: 7am: patient voids and discards specimen; collect all urine for the next 24 hours

  4. Day 2: 7am: patient voids and adds this urine to previously collected urine

  5. On arrival at laboratory, the entire 24-hour specimen is thoroughly mixed, and the volume is measured and recorded
• Types of Urine specimen

  • Random
  • First Morning (8-hour)
  • 24-Hour (or Timed)
  • Catheterized
  • Midstream clean-catch
  • Suprapubic aspiration
  • Three-glass collection
  • Pediatric
• Random


  Most common specimen sent to lab, routine screening, too diluted – inaccurate view of patient's health, lowered analytical values
• First Morning (8-hour)


  Ideal screening specimen, routine screening, pregnancy tests, orthostatic protein, concentrated urine – assuring detection of chemicals and formed elements
• 24-Hour (or Timed)


  Quantitative chemical tests, diurnal variations: catecholamines, 17-hydroxysteroids & electrolytes lowest in early morning & highest conc in the afternoon
• Catheterized


  Sterile, bacterial culture, passing a hollow tube through the urethra into the bladder
• Midstream clean-catch


  Alternative to catheterized specimen, routine screening, bacterial culture, more representative of actual urine than routinely voided specimen, less contaminated with epithelial cells and bacteria
• Suprapubic aspiration


  Sterile, bladder urine for bacterial culture, cytology, collected by external introduction of a needle through the abdomen into the bladder
• Three-glass collection


  Prostatic infection, quantitative cultures for 3 samples (First voided urine, midstream catch and prostatic fluid)
• Pediatric


  Routine screening, bacterial culture
• A specimen for clinical laboratory testing must be properly collected from the correct patient at the correct time with proper patient preparation, and the right test must be performed
• Preanalytical variables


  Appropriateness of test request, proper patient identification and preparation, accurate collection, handling and transport to the laboratory
• Preexamination Variables


  • Test requests
  • Patient Preparation
  • Timing
  • Specimen collection
  • Handling
  • Storage
• Urine Specimen Evaluation


  • Containers: Clean, dry, leak-proof, Disposable, wide mouth, flat bottom and clear material
  • Requisition: Information must match the information on specimen label
  • Labels: Patient's name and ID number, date and time of collection, age
• Specimen Rejection


  • Contaminated specimen
  • No label
  • Nonmatching label and requisition forms
  • QNS
  • Improperly transported
  • Contaminated container
• Specimen Integrity, Preservation, Handling


  • Specimen Integrity
  • Specimen Preservation
  • Specimen Handling
• The normal odor of urine is AROMATIC
• Odor of urine is NOT a part of the routine urinalysis, but should be correlated if otherwise