Urinalysis
Method of Performing Test
Principles of Handling Biological Samples:
General care:
When handling any biological sample ensure that you choose an appropriate setting. Position the sample on a stable, cleanable work surface in a quiet area with good lighting. Ensure that you have appropriate waste disposal facilities and a sink nearby for hand washing.
Personal safety:
Consider your own safety. Ensure that you have any protective equipment necessary. When handling any biological sample you should wear gloves and you may consider wearing an apron.
1. Assemble all your equipment
![Assembled Equipment](images/equipment.jpg)
You will need:
- The urine sample in a labelled bottle
- The urine test strips
- Tissue/paper towels
- Watch/clock/timer which can count in seconds
2. Check the Test Strips
![check expiry date and timing of results on the bottle](images/container.jpg)
Firstly check the expiry date. This is very important as with time the strips deteriorate in quality and colour and may lead to inaccurate results.
At this stage briefly look at the times after which you can read the various results. These will be printed on the side of the container.
NB. Ensure the urine strips test for an appropriate range of factors, e.g. blood, protein and glucose. Click here to learn more about different types of urine test strips.
3. Check the Sample Label
![Check the sample label](images/label.jpg)
Identifying the sample belongs to the correct patient is very important when handling any biological sample. The label should contain the patient’s full name and at least one additional identifier e.g. date of birth, address, hospital number, NHS number. If the patient is present ask them to confirm their details with you.
4. Inspect the Urine
Look at the sample. Urine is usually straw coloured and clear.
Look for changes in:
- Colour
- "Dark": If the urine appears dark it may indicate a concentrated sample or cholestatic jaundice.
- Red: This may indicate blood (frank haematuria). Eating beetroot or taking a drug called rifampicin can also cause a red appearance.
- Turbidity (ie. cloudiness)
- If turbid this could indicate the presence of white blood cells in the urine such as in an infected sample.
- Smell
- Infected urine may have a fishy odour. It can be described as "offensive"
5. Initial Steps
![start timer](images/timer.jpg)
- Remove a urine test strip (replace the lid to prevent deterioration of the test strips)
- Carefully open the urine container.
- Check watch/clock or set timer.
- Briefly fully immerse the test strip in the urine. Ensure all the coloured squares are covered with urine. (DO NOT SOAK)
- Tap the test strip on the side of the container to remove any excess urine and to prevent the dye contaminating adjacent squares.
- Return the sample to a flat surface and close the container to prevent spillage.
![immerse test strip in urine](images/dip.jpg)
6. Reading Results
![comparing stick against bottle / chart](images/chart.jpg)
Hold the stick horizontally or rest on a flat surface. Read against the container or chart as shown. Compare the coloured square on the strip to the closest match on the container or chart.
Ensure that you wait at least the time stated on the container. A chemical reaction will take place between the reagent on the strip and the constituents of the urine and you need to allow enough time for this to happen. Equally it is important to read all the results within 2 minutes otherwise, again, inaccuracies may occur.
- Glucose 30secs
- Protein 60secs
- Blood 60secs
7. Recording Results
![Recordiong results in the patients notes](images/form.jpg)
Record the identifying details of the patient (name, date of birth, hospital number) and the date and time of the test.
In most OSCE's you will have a chart to fill in. In practice when you are writing in the notes results are usually recorded as follows:-
- Glc +
- Prot ++
- Blood +++
Remember that this is a semi-quantitative test.
8. Clear Up
Dispose of your waste correctly. The test strip and container should be placed in a clinical waste bag. The urine should be disposed of in a sluice in a hospital setting. Elsewhere it may be flushed down the sink. Tidy away any other equipment if it is no longer required. Finally wash your hands.
9. Interaction with the patient
If the patient is present thank them and tell them that you have completed the test. You may want to tell them the results if you feel confident to do so and feel able to explain them adequately. Alternatively explain that you will need to inform a senior colleague.