CH. 9: Specimen Collection Pg. 190-195

Chapter 31: Obstructive Pulmonary Disease

COPD - Chronic Bronchitis (Pg. 656-657)

• Definition: Chronic Bronchitis is characterized by a persistent cough and sputum production for at least three months in two consecutive years.

• Pathophysiology: Inflammatory changes in the bronchial epithelium lead to mucus gland hyperplasia and an increase in mucus production, resulting in airway obstruction.

• Symptoms: Symptoms include chronic cough, sputum production, dyspnea, wheezing, and recurrent respiratory infections.

• Diagnosis: Diagnosis is often made through clinical history, pulmonary function tests revealing airflow limitation, and imaging studies.

• Management: Key management strategies include smoking cessation, bronchodilators, corticosteroids, and pulmonary rehabilitation.

Drug Therapy for COPD (Pg. 648-650)

• Bronchodilators: These medications help relax the muscles around the airways, making it easier to breathe. Classes include:

  • Short-acting beta agonists (SABAs)

  • Long-acting beta agonists (LABAs)

  • Anticholinergics

• Inhaled Corticosteroids: Used in patients with frequent exacerbations; they reduce inflammation.

• Phosphodiesterase-4 Inhibitors: They help decrease inflammation and relax the airways, beneficial for severe COPD.

• Antibiotics: These may be prescribed during acute exacerbations to clear infections.

• Oxygen Therapy: For patients with low oxygen levels; improves survival and quality of life.

Evidence-Based Practice: Prevention of Hemolysis of Blood Samples

• Definition: Hemolysis is the breakdown of red blood cells (RBCs) resulting in the leakage of intracellular contents into the plasma, which can affect the accuracy of blood test results.

• Impact: It is a leading cause of preanalytical laboratory errors, leading to inaccurate diagnoses, delayed treatment, monitoring disease progression, and increased costs of care (Makhumula-Nkhoma et al., 2014; McCaughey et al., 2017).

Best Practices to Reduce Hemolysis Rates:

1. Venipuncture: Recommended over obtaining blood samples from IV sites (Barnaby et al., 2016).

2. Optimal Collection Site: Use the antecubital region to minimize hemolysis (McCaughey et al., 2017).

3. Gentle Handling: Avoid vigorous shaking of blood samples, as this can provoke hemolysis and invalidate results (Pagana et al., 2017).

4. Avoid IV Fluids: Collect blood specimens from arms without IV devices when possible (Pagana et al., 2017).

5. Butterfly Needle: Utilizing a butterfly needle significantly decreases the risk of hemolysis (Barnaby et al., 2016; Wollowitz et al., 2013).

6. Tourniquet Application: Do not fasten the tourniquet for longer than 1 minute; prolonged application can cause stasis, localized acidemia, and hemoconcentration (McCaughey et al., 2017).

7. Prompt Processing: Blood specimens should be delivered to the laboratory for processing within 1 hour, as blood cells continue metabolic activity that can alter component concentrations (Pagana et al., 2017).

Safety Guidelines for Specimen Collection

• Purpose of Test: Know the purpose of the test, the amount of specimen needed, appropriate collection technique, and how to transport the specimen to the laboratory (Pagana et al., 2017).

• Identification: The 2019 National Patient Safety Goals by The Joint Commission (TJC, 2019) requires at least two identifiers when providing care, treatment, and services to identify the patient reliably.

Guidelines:

• Standard Precautions: Follow standard precautions (see Chapter 5) when collecting specimens of blood or body fluids.

• Risk of Exposure: Everyone who handles body fluids is at risk for exposure; use hand hygiene and clean gloves when collecting specimens.

• Infection Control: Know agency policy regarding infection control practices for transportation of specimen containers of body substances.

• Biohazard Handling: Use a plastic bag marked “biohazard” to enclose a specimen for delivery to the laboratory.

• Laboratory Requisition: A completed laboratory requisition is needed for each specimen to instruct laboratory personnel and facilitate accurate reporting of results.

• Labeling: After specimen collection, label the container itself (not the lid) with two identifiers, specimen source, collection date and time, series number (if applicable), and anatomical site if appropriate (e.g., knee wound culture vs. abdominal incision).

• Requisition Details: Each requisition includes patient identification, date and time when the specimen is obtained, name of the test, and source of the specimen.

• Special Conditions: Follow procedures for special conditions (e.g., iced specimens, special containers with preservatives) required for transport of specimens. Ensure fasting and NPO conditions are completed before specimen collection (Pagana et al., 2017).

• Timely Delivery: Deliver specimens to the laboratory promptly to avoid additional bacterial growth, which may alter test results (McCaughey et al., 2017; Pagana et al., 2017).

SKILL 9.1 Urine Specimen Collection—Midstream (Clean-Voided) Urine, Sterile Urinary Catheter

Purpose

Urinalysis provides information about kidney or metabolic function, nutrition, and systemic diseases. Urine collection uses a variety of methods, depending on the purpose of the urinalysis and the presence or absence of a urinary catheter. Routine urinalysis includes measurement of nine or more elements, including urine pH, protein and glucose levels, ketones, blood, specific gravity, white blood cell (WBC) count, and presence of bacteria and casts (Pagana et al., 2017).

Types of Urine Tests and Specimens

• Random Urine Specimen: For routine urinalysis in the hospital, a specimen "hat" (Fig. 9.2) is used and placed under the toilet seat to collect voided urine. In an outpatient setting, patients are instructed to void directly into a specimen container.

• Culture and Sensitivity (C&S): This test identifies bacteria causing a urinary tract infection (UTI) and determines the most effective antibiotic for treatment. Use sterile technique to ensure that any microorganisms present originate in the urine and not from the patient's skin, hands, or environment. Specimens for C&S can be collected either as a clean-voided midstream specimen or under sterile conditions from a urinary catheter.

• Timed Urine Specimen: This type of specimen requires urine to be collected over a specific period (2 to 72 hours). The 24-hour timed collection is the most common and allows for measurement and quantitative analysis of excreted elements (see Procedural Guideline 9.1).

Procedural Guideline 9.1: Collecting a Timed Urine Specimen

Purpose

Some tests of renal function and urine composition require urine to be collected over 2 to 72 hours. The 24-hour timed collection is used most often and measures elements such as amino acids, creatinine, hormones, glucose, and adrenocorticosteroids. To ensure the accuracy of a 24-hour timed urine specimen, the patient and staff must work together to collect all voided urine in a 24-hour period.

Delegation and Collaboration in Collecting a Timed Urine Specimen

The skill of collecting a timed urine specimen can be delegated to nursing assistive personnel (NAP). The nurse informs the NAP about the following:

• Timed Collection Instructions: When the timed collection begins, the proper method to store the collected urine, where to place signs indicating that a timed urine collection is in progress, and the need to save all urine.

• Reporting Requirements: The NAP should report if blood, mucus, or foul odors are present in the urine specimen or if there is a break in the collection procedure.

Equipment

• Collection Bottle: Large collection bottle with cap that usually contains a chemical preservative.

• Collection Aids: Bedpan/urinal, specimen hat, bedside commode, or pediatric potty-chair.

• Measuring Tools: Graduated measuring container for intake and output (I&O) measurement.

• Ice Basin: Large basin to hold collection bottle surrounded by ice if immediate refrigeration is required.

• Labeling: Specimen identification label and completed laboratory requisition with appropriate patient identifiers and specimen information.

• Communication Tools: Instructional signs that remind patient and staff of the ongoing timed urine collection.

• Supplies: Clean gloves and a biohazard bag or container as specified by agency policy.

Procedural Steps for Collecting a Timed Urine Specimen

1. Identify Patient: Use at least two identifiers (e.g., name and birthday or name and medical record number) according to agency policy. Compare identifiers with information on patient's MAR or medical record (TJC, 2019).

2. Review Provider's Order: Ensure you understand the health care provider's orders regarding the specimen collection.

3. Explain Procedure: Inform the patient about the reason for the specimen collection, how they can assist in the process, and that the urine must be free of feces and toilet tissue.

4. Label Container: Label the specimen container with all appropriate identification information, numbering the containers sequentially if more than one is needed.

5. Place Container: Place the specimen container in the bathroom and, if indicated, in a pan of ice. Post signs to remind staff, family, visitors, and the patient of the timed urine collection on the patient's door and toileting area. If the patient leaves the unit, ensure that personnel in the receiving area collect and save all urine.

6. Hydration: If possible, have the patient drink two to four glasses of water about 30 minutes before the collection starts to facilitate the ability to void at the appropriate time.

7. Hand Hygiene: Perform hand hygiene and apply gloves. Discard the first voided specimen as the test begins. Indicate the time the test began on the laboratory requisition. For accurate results, the patient must begin the test with an empty bladder. Begin collecting urine for the designated time.

8. Measure Volume: Measure the volume of each voiding if intake and output (I&O) are to be recorded. Place all voided urine in the labeled specimen bottle with appropriate additives/preservatives. NOTE: The type of analysis for the 24-hour timed specimen determines the need for any preservative.

9. Storage: Unless instructed otherwise, keep the specimen bottle in a specimen refrigerator or a container of ice in the bathroom to prevent decomposition of urine.

10. Encourage Hydration: Encourage the patient to drink two glasses of water 1 hour before the timed urine collection ends. Instruct the patient to empty their bladder during the last 15 minutes of the collection period.

11. Collect Final Specimen: Perform hand hygiene and apply clean gloves. Collect the final specimen at the end of the collection period. Label the specimen (with two identifiers, specimen source, collection date and time, number of bottle) in the patient's presence, attach the appropriate requisition, and send it to the laboratory. Remove gloves and perform hand hygiene.

12. Remove Signs: Take down the signs announcing the timed collection. Inform the patient that the specimen collection period is completed.

13. Patient Comfort: Assist the patient into a comfortable position and ensure that the nurse call system is within reach and that the patient is instructed in its use.

14. Documentation: Document the completion of the 24-hour urine collection and its disposition to the laboratory in the patient's medical record.

• Note: The chemical properties of urine are tested by immersing a specially prepared strip of paper (Chemstrip) in a clean urine specimen (see Procedural Guideline 9.2).

Procedural Guideline 9.2: Urine Screening for Glucose, Ketones, Protein, Blood, and pH

Purpose

Tests for chemical properties of urine are part of the routine urinalysis completed in the laboratory or as a point-of-care (POC) test performed at the bedside or in the home. The use of a Multistix reagent test strip may simultaneously assess for up to nine chemical properties: specific gravity, pH, protein, glucose, ketones, blood, bilirubin, urobilinogen, leukocytes, and nitrates. This type of screening is used when more detailed laboratory testing is not available (e.g., health care provider's office, clinic, or long-term care setting). The use of urine testing for managing blood glucose is no longer recommended but continues to be useful in detecting the presence of ketones in patients with diabetes (American Diabetes Association [ADA], 2015).

Delegation and Collaboration in Urine Screening for Chemical Properties

The skill of urine screening for chemical properties can be delegated to nursing assistive personnel (NAP). The nurse informs the NAP to:

• Obtain the Specimen Correctly: Ensure the specimen is collected correctly (e.g., before meals, after a "double-voided" specimen).

• Reporting Requirements: Report the results of the test or any odor, blood, or mucus in the urine specimen.

Equipment

• Bedpan, urinal, specimen hat, bedside commode, or pediatric potty-chair

• Container for urine from catheter

• Watch with second hand or digital counter

• Reagent test strip (check expiration date on container)

• Test strip color chart

• Paper towel

• Clean gloves

• Biohazard bag or container for delivery of specimen to laboratory (as specified by agency)

Procedural Steps for Urine Screening for Chemical Properties

1. Identify Patient: Use at least two identifiers (e.g., name and birthday or name and medical record number) according to agency policy. Compare identifiers with information on patient's MAR or medical record (TJC, 2019).

2. Review Provider's Order: Determine whether a double-voided specimen is needed. If required, ask the patient to void, discard, and then drink a glass of water.

3. Hand Hygiene: Perform hand hygiene and apply clean gloves. Ask the patient to collect a fresh, random urine specimen. If the patient is catheterized, remove a 5-mL specimen from the catheter port (see Skill 9.1).

4. Prepare Reagent Strip: Immerse the end of the reagent strip into the urine container. Remove the strip immediately and tap it gently against the side of the container to remove excess urine.

5. Hold Strip: Hold the strip in a horizontal position to prevent mixing of chemical reagents.

6. Timing and Comparison: Precisely time the number of seconds specified on the container and compare the color of the strip with the color chart on the container (Table 9.1).

7. Discuss Results: When appropriate, discuss test results with the patient. Discard urine and remove/discard gloves; perform hand hygiene.

8. Record Results: Record results immediately on the appropriate testing flow sheet.

9. Patient Comfort: Assist the patient into a comfortable position and ensure the nurse call system is within reach and that the patient is instructed in its use.

TABLE 9.1: Color Chart for Reagent Strip

Delegation and Collaboration in Collecting Urine Specimens

The skill of collecting urine specimens can be delegated to nursing assistive personnel (NAP). The nurse instructs the NAP to:

• Obtain the Specimens: At a specified time when appropriate.

• Patient Positioning: Position the patient as necessary when mobility restrictions are present.

• Reporting Requirements: Report to the nurse if the urine is not clear (e.g., contains blood, cloudiness, or excess sediment).

• Abnormal Signs: Report to the nurse when a patient is unable to initiate a stream or has pain or burning on urination.

Equipment

• Identification labels with the name of the test.

• Completed laboratory requisition, including patient identification, date, time, name of the test, and source of culture.

• Biohazard bag or container for delivery of specimen to laboratory (as specified by agency).

Clean-Voided Urine Specimen

• Commercial Kit for Clean-Void Urine (Fig. 9.3):

  • Sterile cotton balls or antiseptic towelettes

  • Antiseptic solution (chlorhexidine or povidone-iodine solution)

  • Sterile water or normal saline

  • Sterile specimen container

  • Urine cup

• Supplies:

  • Clean gloves

  • Soap, water, washcloth, and towel

  • Bedpan (for nonambulatory patient) or specimen hat (for ambulatory patient)

Sterile Urine Specimen From Urinary Catheter

Supplies

• 20-mL Luer-Lok for routine urinalysis or 3-mL safety Luer-Lok syringe for culture

• Alcohol, chlorhexidine, or other disinfectant swab

• Clamp or rubber band

• Specimen container (nonsterile for routine urinalysis; sterile for culture)

• Clean gloves

Assessment Steps

1. Identify Patient: Use at least two identifiers (e.g., name and birthday or name and medical record number) according to agency policy. Compare identifiers with information on patient's medication administration record (MAR) or medical record.Rationale: Ensures correct patient. Complies with The Joint Commission standards and improves patient safety (TJC, 2019).

2. Review Provider's Order: Review the health care provider's order.Rationale: Ensures accurate testing of specimen; order is needed to perform the test.

3. Refer to Agency Procedures: Refer to agency procedures for specimen collection methods.Rationale: Agency policies may vary regarding collection and/or handling of specimens.

4. Assess Patient's Ability: Assess the patient's ability to help with urine specimen collection; able to position self and hold the container.Rationale: Determines the degree of help patient requires.

5. Assess for Signs of UTI: Assess for signs and symptoms of UTI (frequency, urgency, dysuria, hematuria, flank pain, fever; cloudy, malodorous urine).Rationale: May indicate the need for health care provider intervention.

6. Assess Knowledge and Health Literacy: Assess the patient's or family caregiver's knowledge, experience, and health literacy.Rationale: Ensures that the patient or family caregiver has the capacity to obtain, communicate, process, and understand basic health information (Centers for Disease Control and Prevention [CDC], 2016).

7. Assess Understanding of Test: Assess the patient's or family caregiver's understanding of the purpose of the test and method of collection.Rationale: Allows you to clarify misunderstanding; promotes patient cooperation.

PLANNING

1. Expected outcomes after completion of procedure:

   • Specimen is free of contaminants.Proper collection technique prevents substances from changing normal characteristics of urine.

   • Patient discusses purpose and benefits of the procedure for specimen collection.Procedure is performed safely. Evaluates patient's learning.

2. Perform hand hygiene. Provide privacy for patient; close curtains around bed or close room door. Allow mobile patients to collect specimen in bathroom.

   • Rationale: Reduces transmission of microorganisms. Privacy allows patient to relax and produce specimen more easily.

3. Explain the procedure and what is required of the patient.

   • Rationale: Patients often prefer to obtain their own clean voided specimen but need appropriate education to correctly collect the sample.

IMPLEMENTATION

1. Check labels and verify complete laboratory requisition for specimen container.

   • Rationale: Organizes procedure.

2. Perform hand hygiene.

   • Rationale: Reduces transmission of microorganisms.

3. Collect clean-voided urine specimen.

   • a. Apply clean gloves. Give patient cleaning towelette or towel, washcloth, and soap to clean perineum or help with cleaning perineum. Help bedridden patient onto bedpan to facilitate access to perineum. Remove and dispose of gloves and perform hand hygiene.

     • Rationale: Patients prefer to wash their own perineal areas when possible. Cleaning prevents contamination of specimen from skin and surface bacteria after urine passes from urethra.

   • b. Using aseptic technique, open outer package of commercial specimen kit.

     • Rationale: Maintains sterility of equipment.

   • c. Apply clean gloves.

     • Rationale: Prevents contact of microorganisms on your hands.

   • d. Pour antiseptic solution over cotton balls (unless kit contains prepared antiseptic towelettes).

     • Rationale: Cotton ball or towelette is used to clean perineum.

   • e. Open specimen container, maintaining sterility of inside specimen container, and place cap with sterile inside up. Do not touch inside of cap or container.

     • Rationale: Contaminated specimen is the most frequent reason for inaccurate reporting of urine C&S.

   • f. Use aseptic technique to help patient or allow patient to independently clean perineum and collect specimen. Amount of help needed varies with each patient. Inform patient that antiseptic solution will feel cold.

     • Rationale: Maintains patient's dignity and comfort.

     • (1) Male:

       • (a) Hold penis with one hand; using circular motion and antiseptic towelette, clean meatus, moving from center to outside 3 times with different towelettes. Have uncircumcised male patient retract foreskin for effective cleaning of urinary meatus and keep retracted during voiding. Return foreskin when done.- Rationale: Reduces number of microorganisms at urethral meatus and moves from areas of least to most contamination. Return of foreskin prevents stricture of penis.

       • (b) If agency procedure indicates, rinse area with sterile water and dry with cotton balls or gauze pad.- Rationale: Prevents contamination of specimen with antiseptic solution.

       • (c) After patient initiates urine stream into toilet, urinal, or bedpan, have him pass urine specimen container into stream and collect 90-120 mL of urine.- Rationale: Initial urine flushes out microorganisms that normally accumulate at urinary meatus and prevents transfer into specimen.

     • (2) Female:

       • (a) Either nurse or patient spreads labia minora with fingers of nondominant hand.- Rationale: Provides access to urethral meatus.

       • (b) With dominant hand, clean urethral area with antiseptic swab (cotton ball or gauze). Move from front (above urethral orifice) to back (toward anus). Use fresh swab each time; clean 3 times; begin with labial fold farthest from you, then labial fold closest, and then down center.- Rationale: Prevents contamination of urinary meatus with fecal material. Cleaning down the center last decreases contamination from labia.

       • (c) If agency procedure indicates, rinse area with sterile water and dry with cotton ball.- Rationale: Prevents contamination of specimen with antiseptic solution.

       • (d) While continuing to hold labia apart, patient initiates urine stream into toilet or bedpan; after stream is achieved, pass specimen container into stream and collect 90-120 mL of urine.- Rationale: Initial stream flushes out resident microorganisms that accumulate at urethral meatus and prevents transfer into specimen.

   • g. Remove specimen container before flow of urine stops and before releasing labia or penis. Patient finishes voiding into bedpan or toilet. Offer to help with personal hygiene as appropriate.

     • Rationale: Prevents contamination of specimen with skin flora. Prevents sediment from bladder getting into specimen.

   • h. Replace cap securely on specimen container, touching only the outside.

     • Rationale: Retains sterility of the inside of the container and prevents spillage of urine.

   • i. Clean urine from the exterior surface of container.

     • Rationale: Prevents transfer of microorganisms to others.

4. Collect urine from indwelling urinary catheter.

   • a. Explain that you will use a syringe without a needle to remove urine through catheter port and that patient will not experience any discomfort.

     • Rationale: Minimizes anxiety when you manipulate the catheter and aspirate urine with a syringe from catheter port.

   • b. Explain that you will need to clamp catheter for 10-15 minutes before obtaining urine specimen and that urine cannot be obtained from drainage bag.

     • Rationale: Allows urine to accumulate in catheter. Urine in the drainage bag is not considered sterile.

   • c. Apply clean gloves. Clamp drainage tubing with clamp or rubber band for as long as 15 minutes below site chosen for withdrawal.

     • Rationale: Permits collection of fresh sterile urine in catheter tubing rather than draining into the bag.

   • d. After 15 minutes, position patient so catheter sampling port is easily accessible. Clean the port for 15 seconds with disinfectant swab and allow to dry.

     • Rationale: Prevents entry of microorganisms into catheter.

   • e. Attach needleless Luer-Lok syringe to built-in catheter sampling port. Some needleless ports use a blunt plastic valve or slip-tip syringe inserted into port diaphragm.

     • Rationale: Guideline recommends use of Luer-Lok needleless system. Needleless system prevents injury by needlestick.

   • f. Withdraw 3 mL for culture or 20 mL for routine urinalysis.

     • Rationale: Allows collection of urine without contamination. Proper volume is needed to perform the test.

   • g. Transfer urine from syringe into clean urine container for routine urinalysis or into sterile urine container for culture.

     • Rationale: Prevents contamination of urine during the transfer procedure.

   • h. Place lid tightly on container.

     • Rationale: Prevents contamination of specimen by air and loss by spillage.

   • i. Unclamp catheter and allow urine to flow into drainage bag. Ensure that urine flows freely.

     • Rationale: Allows urine to drain by gravity and prevents stasis of urine in the bladder.

5. Securely attach label to the container (not lid). If patient is female, indicate if she is menstruating. In presence of patient, complete label (two identifiers, specimen source, collection date and time) and attach to container. Attach completed laboratory requisition to container. Enclose specimen in a biohazard bag and send immediately to the laboratory.

   • Rationale: Incorrect patient identification could lead to diagnostic or therapeutic error (TJC, 2019). Bacteria multiply quickly. Specimen should be analyzed promptly for accurate results.

6. Dispose of soiled supplies. Remove and dispose of gloves and perform hand hygiene.

   • Rationale: Prevents transmission of microorganisms.

7. Offer patient hand hygiene or provide time to wash hands.

   • Rationale: Reduces transmission of microorganisms.

8. Assist patient to comfortable position.

   • Rationale: Promotes patient comfort.

9. Ensure nurse call system is accessible within reach and instruct the patient in its use.

   • Rationale: Ensures patient can call for assistance if needed.

10. Raise side rails (as appropriate) and lower bed to lowest position.

• Rationale: Ensures patient safety.

11. Send specimen and completed requisition to the laboratory within 20 minutes. Refrigerate the specimen if delay cannot be avoided.

• Rationale: Delay of analysis may significantly alter test results (Pagana et al., 2017).

EVALUATION

1. Inspect clean-voided specimen for contamination with toilet paper or stool.

   • Rationale: Contaminants prevent specimen from being used.

2. Evaluate patient's urine C&S laboratory report for bacterial growth.

   • Rationale: Routine cultures identify organism(s), and sensitivity study identifies antimicrobial medications that may be effective against the pathogen.

3. Observe urinary drainage system in catheterized patient to ensure that it is intact and patent.

   • Rationale: System must remain closed to stay sterile.

4. Use Teach-Back: "I want to be sure I explained the way to obtain a clean-voided specimen. Please repeat the steps back to me." Revise your instruction now or develop a plan for revised patient/family caregiver teaching if the patient/family caregiver is not able to teach back correctly.

   • Rationale: Determines patient's/family caregiver's level of understanding of the instructional topic.

Unexpected Outcomes and Related Interventions

1. Urine specimen is contaminated with stool or toilet paper.

   • Intervention: Repeat patient instruction and specimen collection. If unable to obtain specimen through clean voiding, patient may need catheterization (see Skill 19.2).

2. Patient is unable to void, or urine does not collect in drainage tube.

   • Intervention: Offer fluids if permitted to enhance urine production.

3. Urine culture reveals bacterial growth (determined by colony count of more than 10,000 organisms per milliliter).

   • Intervention: Report findings to health care provider.

   • Administer medications as ordered.

   • Monitor patient for fever and dysuria.

4. Lumen leading to balloon that holds catheter in place is punctured.

   • Intervention: Notify health care provider.

   • Prepare for removal of existing catheter and insertion of new catheter.

Recording

• Documentation: Record the following details in the patient's medical record:

  • Method used to obtain specimen

  • Date and time collected

  • Type of test ordered

  • Laboratory receiving specimen

  • Characteristics of specimen

  • Patient's tolerance to procedure of specimen collection.

• Evaluation: Document your evaluation of patient learning.

Hand-Off Reporting

• Report Details: During hand-off reporting, ensure to report:

  • The type of urinalysis performed.

  • When the specimen was sent to the laboratory.

• Abnormal Findings: Report any abnormal findings from the urinalysis to the health care provider.