Pre‐procedure

ActionRationale

1. 1.Show
   Introduce yourself to the patient, explain and discuss the procedure with them, and gain their consent to proceed.
   To ensure that the patient feels at ease, understands the procedure and gives their valid consent (NMC [144], C).
2. 2.Show
   Wash and dry hands and/or use an alcohol‐based handrub and put on gloves and apron.
   To maintain infection control and prevent cross‐infection (NHS England and NHSI [124], C).

Procedure

1. 3.Show
   Check the reagent sticks have been stored in accordance with the manufacturer's instructions. This is usually a dark, dry place in an airtight container.
   To ensure reliable results. Tests may depend on enzymic reaction, so expired, contaminated or improperly stored strips can give false‐positive results (e.g. in leucocyte and blood readings) (Delanghe and Speeckaert [53], C).
2. 4.Show
   Prepare the sample area:

   • If taking the specimen from a urinary catheter, it should be collected using an aseptic technique via the catheter side port.
   • For women, the labia should be separated with cotton wool or a sponge moistened with water, and the vulva should be wiped from the front to the back, although disinfectant must never be used.
   • Men should clean the glans penis with soap and water.
   To reduce sample contamination (Adam et al. [2], C).
3. 5.Show
   Instruct the patient that, to obtain a clean, midstream specimen of fresh urine, they should allow a few millilitres of urine to pass into the toilet (not collected), then introduce a container or sterile receptacle into the urine stream. Once a sufficient sample has been collected, the remaining urine can pass into the toilet.
   To ensure that any contaminating bacteria in the urethra are flushed out first and the sample represents the bladder contents (Adam et al. [2], C).
4. 6.Show
   Dip the reagent strip into the urine. The time that the dipstick remains in the urine should be governed by the manufacturer^’s recommendations. The strip should be completely immersed in the urine and then removed. Run the edge of the strip along the container to remove excess urine.
   To ensure accuracy and to remove any excess urine, preventing mixing of chemicals from adjacent reagent areas (Provan [167], C).
5. 7.Show
   Hold the stick sideways in a horizontal position.
   Urine reagent strips should not be held upright when reading them because urine may run from square to square, mixing the different reagents (Provan [167], C).
6. 8.Show
   Wait the required time, as per the manufacturer's instructions, before reading each test on the strip against the colour chart.
   The strips must be read at exactly the time interval specified or the reagents will not have had time to react or may display an inaccurate result (Provan [167], C).

Post‐procedure

1. 9.Show
   If an abnormality is found (Table 14.14), the urine sample should be sent to the laboratory for a more detailed analysis; otherwise, dispose of the sample appropriately in either the sluice or a toilet. Dispose of the urinalysis stick and gloves in the correct wastage bin. Ensure the cap on the package of urine reagent strips is replaced immediately and closed tightly.
   To prevent misdiagnosis and to ensure strips are stored in an airtight container according to storage guidelines (Bardsley [12], C).
2. 10.Show
   Wash and dry hands and/or use an alcohol‐based handrub.
   To maintain infection control and prevent cross‐infection (NHS England and NHSI [124], C).
3. 11.Show
   Document urinalysis readings and inform medical staff of any abnormal readings.
   To allow prompt action if a change of treatment plan is required (NMC [144], C).