Collection a midstream urine specimen 

Authors: Брикез Ю. И.

Editor: Редненко В. В.

Description of the clinical situation:

You are a ward nurse of an inpatient health care organization. An urine specimen  by Nechiporenko has been ordered for a patient. Prepare the patient and collect urine specimen by Nechiporenko.

Indications: Nechiporenko urine specimen is used for quantitative determination of urine forms elements (erythrocytes, leukocytes, urinary cylinders) for the purpose of patient examination.

Equipments:

• clean, dry container of at least 50 ml with a lid for urine collection
• a referral for examination:бланк «Анализ мочи по Нечипоренко» 

Procedure for performing the practical skill:

Preparatory stage:

• say hello to the patient, introduce yourself
• check the patient's name, check with a MAR (medication administration record)
• the day before (evening) inform the patient about the upcoming urine collection by Nechiporenko, obtain verbal consent for the collection.
• Fill in the referral  «Анализ мочи по Нечипоренко»: indicate patient's surname, first name, year of birth, gender, department, ward number, date of urine collection
• teach urine collection techniques

Main stage:

• give the completed  referral and urine collection container to the patient
• explain the urine collection rules to the patient:
• in the morning before collecting urine perform the daily washing the external genitalia
• while urinating collection a midstream urine specimen:
• first, release a small amount of urine into the toilet
• hold urination
• then continue urinating and collect at least 10 ml of urine in a container.
• finish urinating into the toilet.
• close the container with a lid
• leave the urine in the sanitary room in a special box for storing urine samples (for an outpatient, take the urine to the laboratory)

Final stage:

• the ward nurse ensures delivery of the samples to the laboratory of the health care organization before 8 a.m. in a container for transportation of biological material samples, enclosing the referral forms in a separate bag
• the ward nurse staples the results of the laboratory tests to the medical card of an inpatient.

 Note:

• If the patient is on a bed regime, the ward nurse should collect the urine specimens
• If the patient on period on ​​the day of the examination, close the vagina with a tampon when urinating. In emergency, urine collection is done by catheter.
• It is allowed to store urine in the refrigerator at +4°C for no more than a day, if it is impossible to transport it to the laboratory within the first two hours after collection