- A non-invasive method of collecting urine from a patient, while preventing germs from the penis or vagina from getting into the specimen is:
Rationale: A clean-catch urine specimen is the most common method of collecting a bacteria-free specimen without the use of a catheter. Urine specimens may be ordered for numerous reasons, typically to diagnose infections or check certain functions or levels in the body. It is important for the specimen to be as sterile as possible, which can be achieved by educating the patient on certain steps to take while collecting the specimen.
- Before a patient urinates in a container for a clean-catch specimen, they should first wash their hands and:
clean the labia or penis with a towelette
Rationale: It is important to thoroughly cleanse the labia or penis with a moist sterile towelette prior to giving a urine specimen. A towelette will be provided in the collection kit provided to the patient. Urine is a sterile fluid while it is inside of the body, and should remain as sterile as possible for adequate testing when it is collected. The purpose of cleaning thoroughly before urinating into the container is to prevent contamination of the urine by germs on the outside of the body.
- Female patients should be instructed to clean with a moist towelette prior to urinating, while wiping:
front to back
Rationale: A female patient should cleanse the labia with a moist towelette prior to giving a urine specimen. Wiping the labia from front to back is essential to prevent any contamination of stool or vaginal content into the urine specimen.
- When a clean-catch urine specimen is needed, it is important to instructed female patients to:
separate the labia before cleaning with towelette
Rationale: The labia is the outer "lips" of the female genitalia. It is essential to separate the labia, and to cleanse thoroughly prior to urinating. The area should be cleansed front to back. This will prevent contamination of the sterile urine while it is collected.
- When sending a patient in to the restroom for a clean-catch urine specimen, be sure to instruct them not to:
touch the inside of the cup
Rationale: The container provided to a patient for a clean-catch specimen will have a lid, with a closed sterile container. It is important that the container remain sterile so that the urine specimen does not become contaminated with germs. Be sure to instruct patient to only touch the outside of the container, and to not touch the lid or inside of the cup.
- To assure an adequate amount of urine for testing, the patient should fill the container:
at least half-full
Rationale: There are several tests that may be ordered on a urine specimen. It is essential that enough urine be collected to perform all tests that the doctor may order. Take the cup and show the patient how far up they should fill it prior to going into the restroom. If a patient is unable to fill the cup as full as necessary, go ahead and send the specimen, but instruct the patient that another specimen may be required if enough urine was not sent the first time.
- Patients should be instructed to urinate into the container for a clean-catch urine specimen :
Rationale: Catching the urine "midstream" means that a patient starts to urinate into the toilet, before collecting urine into the container. A patient should be instructed to urinate until a steady flow is present, then insert the cup into the stream for collection. The purpose of this is to assure that most sterile and useful urine is collected for testing.
- When collecting a clean-catch urine specimen for a male patient that is uncircumcised, they should be instructed to:
retract the foreskin before cleansing with the towelette
Rationale: A urine specimen should be as sterile as possible for testing. The foreskin on a male contains bacteria that will contaminate a urine specimen, and it is necessary to cleanse the area with a towelette prior to collecting the urine. The male should be instructed to retract the foreskin back completely, and not just cleanse the tip of the penis.
- Ideally, the best urine specimen is urine that has been in the bladder for:
Rationale: The most accurate urine tests are performed on urine specimens that have been in the body for 2-3 hours. This allows higher concentration of the urine, and the ability to get more levels on whatever is being tested. Urine that is diluted, or has not been in the bladder for a longer period of time, will not have as accurate levels as urine that has been in the body for at least 2-3 hours.
- Prior to sending a urine specimen to the lab, it should be labeled with:
name, birth date, and collection time
Rationale: It is important to assure that all specimens sent to the lab are labeled according to policy for your place if employment. There should be at least 2 identifiers present on a label to assure that the specimen is not mixed up with another patient. The label should contain at least a last name and first initial, as well as birth date and the time that the urine was collected. Some facilities will also have patient ID numbers, that are unique to their facility.