This study is based on trial results, including urinalysis (a test of urine) results and experience results, of a newly developed urine collection method (referred to as UCollect). 

The analysis of a urine sample can for example be required for the diagnosis of urinary tract infections, which is a common infection in older adults. In Dutch care homes the average point prevalence is 1.7%. 

Many older adults with need for care need help in obtaining a urine sample but current methods are often experienced as painful and derogatory by the older adults and as time inefficient by caregivers, who need to help the older adults. The toilet hat method could require the older adult to sit on a toilet for a long time. The catheter method is invasive and could result in a urinary tract infection and even may cause pain.

The aim of this study is to provide proof of concept of a new urine collection method, which is wearable, allows mobility to the older adults, protects their dignity and privacy and relieves the caregivers. It is based on data gathered in field tests about the quality of the urine samples and the older adults and caregivers experience with the UCollect system. The hypothesis of this study is that UCollect could be used as an alternative to conventional methods in collecting a urine sample on the target group.

During the whole process we followed the principles of Human Centred Design, that means the target group, the older adults suffering from incontinence, and the caregivers, were involved in all phases, which are the inspiration, ideation, prototyping and evaluation phases.[1]
Data from three older adults in the control trial group (using the conventional toilet hat method) and three older adults in the UCollect trial group was included in the trial phase one. Older adults and caregiver feedback was used to improve the UCollect system. Data from five older adults in the control trial group (using the conventional toilet hat method) and 10 older adults in the UCollect trial group (using the improved UCollect system) was included in the trial phase two.

The innovative UCollect is a wearable ergonomic collector for women which was placed in the diaper of the older adult. A wireless sensor was connected to the collector and detected when enough urine was gathered for urinalysis. A notification message was sent by the wireless sensor to a caregiver app to notify that the urine could be extracted from Ucollect and prepared for diagnosis.
In the two trials, with an update of the collector design in between, a urine sample was gathered from older adults using the conventional toilet hat method and the UCollect method. The urine samples were sent to a laboratory for analysis to get insight into the quality of the urine sample gathered with the UCollect, in comparison to the control urine samples. The older adults and caregivers      also filled in a questionnaire regarding their user experience with the UCollect (see please Figure 1).

In the trial phase one, one out of three urine samples, collected with the UCollect, had enough quantity to be send to a laboratory. For the control samples, collected with the toilet hat method, this was three out of three samples. Urinalysis results showed that bacteria were present within the same acceptable range in all the urine samples: both in the one sample collected with UCollect and three samples collected with the toilet hat method. 
Three out of three older adults found the UCollect comfortable to wear and a non-derogatory way of urine collection. One caregiver found the UCollect easy to handle, one caregiver found the collector not easy to handle, one caregiver found the collector both easy and not easy to handle (see Figure 1).

In the trial phase two, 7 out of 10 urine samples, collected with the UCollect, had enough quantity to be sent to a laboratory. For the control samples, collected with the toilet hat method, three out of three samples had enough quantity to be sent to the laboratory. Urinalysis results showed that bacteria were present in the same range in all the collected urine samples [2].

Older adults are more likely to develop bacteriuria, which is bacteria in the urinary tract [3]. Due to this it can’t be sure if the pathogen bacteria are from contamination or if the bacteria are from a non-symptomatic urinary tract infection.

Most older adults and caregivers found the UCollect comfortable to wear and a non-derogatory method for urine collection. Most, especially the caregivers, also found the UCollect easy to handle.

The UCollect system: a wearable ergonomic urine collector which would be worn inside an incontinence diaper, with urine sensor and notification system, would be able to support older adults and their caregivers in collecting a urine sample for healthcare purposes. Alongside, the UCollect method provide a feeling of dignity and comfort to the older adult while collecting a urine sample and Ucollect reduces stress for both target groups, the older adults and the caregivers. The urine sample quality is comparable with the current conventional methods.

IDEO, Ed., The field guide to human-centered design: design kit, 1st. ed. San Francisco, Calif: IDEO, 2015. [Online]. Available: http://www.designkit.org//resources/1
M. T. LaRocco et al., ‘Effectiveness of Preanalytic Practices on Contamination and Diagnostic Accuracy of Urine Cultures: a Laboratory Medicine Best Practices Systematic Review and Meta-analysis’, Clin. Microbiol. Rev., vol. 29, no. 1, pp. 105–147, Jan. 2016, doi: 10.1128/CMR.00030-15
C. Chen, Y. Wu and T. Dong, Dipsticks integrated on smart diapers for colorimetric analysis of urinary tract infections in the field, International Conference on Mechatronics-Mechatronika, 2014