Specimen Collection

Specimen Collection Policy 

Purpose 

To collect body substances and fluids for diagnostic testing accurately and safely. 

Procedure 

Twenty-Four Hour Urine Specimen Collection 

Note: Must be kept on ice or in a refrigerator. 

Steps: 

• Obtain a large gallon specimen container from the laboratory and label it properly. 

• Discard the first voiding and label the container with the date and time the first specimen is collected. 

• Save all urine voided thereafter until the same time 24 hours later. 

• Post a note saying "SAVE ALL URINE (RESIDENT'S NAME)" in the resident's bathroom and in the utility room. 

• Include the date and time the 24-hour urine specimen collection began in the nursing report. 

• If any urine is discarded, check with the laboratory to determine if the test should be abandoned and restarted with a clean container. 

Sputum Specimen Collection 

Steps: 

• Assemble equipment, bring to the bedside, explain the procedure to the resident, and screen for privacy. 

• If possible, secure the specimen before breakfast (for TB testing, always save the first specimen of the morning). 

• Instruct the resident to expectorate material coughed from the lungs (not by clearing the back of the throat) into the specimen container. Label the container accurately. 

• Instruct the resident to take care not to contaminate the outside of the container. 

• Store the specimen properly. 

Vomitus Specimen Collection 

Steps: 

• Assemble equipment, bring to the bedside, explain the procedure to the resident, and screen for privacy. 

• Place the specimen in a container and label it accurately. 

• Store the specimen properly. 

Documentation 

• Document the collection in Nurse’s Notes and the 24-Hour Report. 

References: 

• Centers for Medicare & Medicaid Services (CMS), Requirements of Participation for Long-Term Care Facilities. 

• State Operations Manual (SOM), CMS.