The Royal Marsden Hospital Manual of Clinical Nursing Procedures - Lisa Dougherty [432]
8 Place the wide-necked sterile container into the urine stream without interrupting the flow. To prevent contamination of specimen and ensure the collection of the midstream of urine which most accurately represents the urine in the bladder (Gilbert 2006, E).
9 Ask the patient to void his remaining urine into the urinal, toilet or bedpan. For patient to comfortably continue passing urine. E
10 Transfer specimen into sterile universal container. For despatch to the laboratory. E
11 Allow patient to wash hands. To maintain personal hygiene. E
Postprocedure
12 Label sample and complete microbiological request form including relevant clinical information, such as signs and symptoms of infection, antibiotic therapy. To maintain accurate records and provide accurate information for laboratory analysis (NMC 2009, C; Weston 2008, E).
13 Dispatch sample to laboratory immediately (within 2 hours) or refrigerate at 4°C. To ensure the best possible conditions for microbiological analysis and to prevent micro-organism proliferation (Higgins 2007, C).
Procedure guideline 11.14 Urine sampling: midstream specimen of urine: female
Essential equipment
Cleaning solution (e.g. soap and water, 0.9% sodium chloride or disinfectant-free solution)
Sterile specimen container (with wide opening)
Gloves
Apron
Appropriate documentation/forms
Preprocedure
Action Rationale
1 Discuss need and indication for procedure with patient. To obtain valid consent (NMC 2008b, C).
2 Fully explain the steps of the procedure. The procedure requires the patient to fully understand the procedure in order to avoid inadvertent contamination of specimen and optimize the quality of the sample (Higgins 2008, C).
3 Ensure a suitable, private location. To maintain patient privacy and dignity (Gilbert 2006a, E).
Procedure
4 Ask patient to wash hands with soap and water. To reduce risk of cross-infection (DH 2007a, C).
5 If practitioner’s assistance required: wash hands with bactericidal soap or decontaminate physically clean hands with alcohol rub and don apron. To prevent cross-contamination (DH 2007a, C).
6 Ask patient to part the labia and clean the urethral meatus with soap and water, 0.9% sodium chloride or a disinfectant-free solution. To optimize general cleansing and to minimize other organisms contaminating the specimen. E
Disinfectant solutions may irritate the urethral mucous membrane (Higgins 2007, C).
7 Use a separate swab for each wipe and wipe downwards from front to back. To prevent cross-infection and perianal contamination (Weston 2008, E).
8 Ask patient to begin voiding first stream of urine (approx. 15–30 mL) into a toilet or bedpan whilst separating the labia. To commence the flow of urine and avoid contamination of specimen with naturally occurring micro-organisms/flora within the urethra (Rigby and Gray 2005, E).
9 Place the wide-necked sterile container into the urine stream without interrupting the flow. To prevent contamination of specimen and to ensure the collection of the midstream of urine which most accurately represents the urine in the bladder (Gilbert 2006, E).
10 Ask the patient to void her remaining urine into the toilet or bedpan. For patient to comfortably continue passing urine. E
11 Transfer specimen into sterile universal container. For dispatch to the laboratory. E
12 Allow patient to wash hands. To maintain personal hygiene. E
Postprocedure
13 Label sample and complete microbiological request form including relevant clinical information, such as signs and symptoms of infection, antibiotic therapy. To maintain accurate records and provide accurate information for laboratory analysis (NMC 2009, C; Weston 2008, E).
14 Dispatch sample to laboratory immediately (within 2 hours) or refrigerate at 4°C. To ensure the best possible conditions for microbiological analysis and to prevent micro-organism proliferation (Higgins 2007, C).
Procedure guideline 11.15 Urine sampling: catheter specimen of urine (CSU)
Essential equipment