Ensuring Urine Sample Quality – URINE FOR URINALYSIS
Along with blood, urine is one of the most frequently analyzed specimen materials in the laboratory, although urine as a specimen is rarely used as a single source to diagnose diseases. It is, however, an easily obtainable sample and can be a good indicator that helps clinicians determine what to focus on or if additional testing is needed, for example to diagnose diabetes or kidney disease. To enable this, good sample quality is essential.
Because urine is inherently unstable, changing composition as soon as it leaves the body, sample quality depends on proper collection, transport, storage and handling. One of the biggest factors in urine sample quality is the patient themself. Unless a catheter is being used, the patient alone is responsible for collecting the specimen. Guidance from healthcare professionals is therefore crucial.
Explaining the types of urine samples and how to ensure test specimen quality can help and is the duty of the healthcare professional.
| Appropriate and hygienic specimen cup | A clean or ideally sterile cup with a lid should be used – keep the inside of the cup clean by not touching the lid inner or placing the inside of lid down on a surface. |
| Hygiene – body / genitals | Foreign material, for example skin bacteria, dirt or fecal matter, could contaminate a sample. The patient should wash their hands and clean the genital area thoroughly before providing the specimen. |
| Type of sample: clean mid-stream | A frequently requested specimen for urinalysis is clean-catch mid-stream. It is important to explain to the patient what this means. First, the initial urine stream should be allowed to flow into the toilet, then the urine stream can be collected as sample. This also helps prevent contamination. |
| Preservation | If a specimen is not collected at a healthcare facility, it should be brought as soon as possible. If immediate transportation is not possible, the specimen should be refrigerated, as containers do not contain a preservative. |
Prevent negative impact: healthcare workers
Depending on the facility’s procedure, it may not be possible to transfer a urine specimen immediately into a sample transport tube with preservatives to keep the sample stable.
✅In this case, it is important to label the cup – not the lid, the lid can get misplaced - with clear patient identification.
✅If it is not possible to transfer the specimen from the cup into a preservation and transport tube, the sample cup can be stored in the refrigerator for up to two hours.
Some facilities may carry out immediate procedures, such as with a chemistry dipstick or visual sample observation. If multiple tests are needed, it is important to take aliquots or transfer the sample into the appropriate sample tubes. A chemistry dipstick could otherwise contaminate the sample for subsequent tests.
Conclusion
A poor-quality sample can result in incorrect analytical results and subsequent misdiagnosis. Such errors can lead to re-collection and repeat analysis, which not only impacts the patient, but also increases analysis time and cost. By supporting patients with education and guidance through self-collection and adhering to best practices for transport and handling, clinicians can ensure optimal specimen quality for urinalysis – leveraging one of the lab’s most common and time-tested diagnostic tools.
Disclaimer
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