Obtaining A Sterile Urine Specimen From A Catheter

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Procedure 27-2B Obtaining a Sterile Urine Specimen from a Catheter

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Steps 1-10

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Step 1

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Empty the drainage tube of urine.

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Step 2

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Clamp the drainage tube below the level of the specimen port for 15 to 20 minutes to allow a fresh sample to collect. If the client's urine is flowing briskly, you may not need to clamp the catheter.

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Step 3

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Don clean procedure gloves, and swab the specimen port with an antiseptic swab.

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Step 4

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Insert the needleless access device with a 20 or 30 mL syringe into the specimen port, and aspirate to withdraw the amount of urine you need.

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Step 5

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Once you have the sample, transfer the specimen into a sterile specimen container.

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Step 6

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Discard the needleless access device and syringe in a safe container. (Done to protect against needlestick injury)

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Step 7

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Tightly cap the specimen container.

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Step 8

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Remove the clamp from the catheter. Be sure to unclamp the tubing of the urinary collection bag after you obtain the sample. (Urine backflow can cause bladder distention and lead to stasis induced UTI).

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Step 9

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Label and package the specimen with the correct patient identification according to agency policy. (Avoid a wrong patient error)

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Step 10

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Transport the specimen to the lab. If immediate transport is not possible, refrigerate the sample.

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Never disconnect the catheter from the drainage tube to obtain a sample.

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Rationale: Interrupting the system creates a portal of entry for pathogens thereby, increasing the risk of contamination

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Evaluation

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1. Note any unusual characteristics of the urine. (Color, odor, clarity, crystals, blood, mucus)
2. Note any difficulties with urinating. (Pain, burning, dribbling, difficulty beginning)

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Equipment

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Clean gloves

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Equipment

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Antiseptic Swab

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Equipment

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Sterile Specimen Container with a lid

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Equipment

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Patient Identification Label

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Equipment

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Sterile Syringe with a Sterile 21 to 25 gauge needleless access device (5 to 10 mL syringe is usually sufficient)

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Patient Teaching for Procedure 27-2 Obtaining a Urine Specimen for Testing

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For Clean Catch and 24 hour urine specimens, teach the patient the steps of the procedure, focusing on how to maintain the sterility of the specimen

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Patient Teaching for Procedure 27-2 Obtaining a Urine Specimen for Testing

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Tell patient to refrigerate a urine specimen for up to 24 hours until it is transported to the lab. Instruct the patient to place the specimen in a plastic bag, separate it from food items, and label it appropriately

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Patient Teaching for Procedure 27-2 Obtaining a Urine Specimen for Testing

Card 3

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Explain that prepackage antiseptic wipes cannot be flushed down the toilet.

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Patient Teaching for Procedure 27-2 Obtaining a Urine Specimen for Testing

Card 4

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For clean-catch and 24 hour urine specimens, instruct a menstruating women that perineal cleaning is important. The woman may use a tampon to prevent leakage during specimen collection. Instruct her to notify the lab that she is menstruating.

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Procedure 27-2 Obtaining a Urine Specimen for Testing

Documentation Card 1

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Document urine volume in the patient record, per agency protocol, the time, and date that the specimen was collected.

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Procedure 27-2 Obtaining a Urine Specimen for Testing

Documentation Card 2

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Document the characteristics of the urine: color, odor, particular matter, blood, clarity, or other qualities.

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Patient Teaching for Procedure 27-2 Obtaining a Urine Specimen for Testing

Documentation Card 3

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Document any difficulty voiding, including pain, or burning with urination, frequency, or difficulty starting the urine flow.

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Procedure 27-2 Obtaining a Urine Specimen for Testing

Documentation Card Special Things

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Some facilities have specimen collection in the nursing notes or the EHR