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Sterile gloves

Apron

Syringe (and needle if not a needle-free system)

Non-traumatic clamps

Alcohol-based swab

Universal specimen container

Appropriate documentation/forms

Optional equipment

Non-sterile gloves

Preprocedure

Action Rationale

1 Explain and discuss the procedure with the patient. To ensure the patient understands the procedure and gives valid consent (NMC 2008b, C).

2 Ensure a suitable, private location. To maintain patient privacy and dignity (Gilbert 2006, E).

3 Prepare equipment and place on sterile trolley.

Procedure

4 If no urine visible in catheter tubing: wash/decontaminate physically clean hands with alcohol rub, don apron and apply non-sterile gloves prior to manipulating the catheter tubing. To minimize the risk of cross-infection (Pellowe 2009, C).

5 Apply non-traumatic clamp a few centimetres distal to the sampling port. To ensure sufficient sample has collected to allow for accurate sampling (Higgins 2008, C).

6 Wash hands with bactericidal soap and water, or decontaminate physically clean hands with alcohol rub and don sterile gloves. To prevent cross-contamination (DH 2007a, C).

7 Wipe sampling port with 2% chlorhexidine in 70% isopropyl alcohol and allow drying for 30 seconds. To decontaminate sampling port and prevent false-positive results (DH 2007a, C).

8 If using needle and syringe: using a sterile syringe and needle, insert needle into port at an angle of 45° and aspirate the required amount of urine, then withdraw needle.

Or in a needle-less system: insert syringe firmly into centre sampling port (according to manufacturer’s guidelines), aspirate the required amount of urine and remove syringe.

To enable safe inoculation of urine specimen and to minimize the risk of penetration of the wall of the catheter tubing (Hampson 2006, C)

Reduces the risk of sharps injury (DH 2006, C).

9 Transfer an adequate volume of the urine specimen (approx. 10 mL) into a sterile container immediately. To avoid contamination and to allow for accurate microbiological processing (Gilbert 2006, E).

10 Discard needle and syringe into sharps container. To prevent the risk of needlestick injury. E

11 Wipe the sampling port with an alcohol wipe and allow to dry. To reduce contamination of access port and to reduce risk of cross-infection (DH 2007b, C).

Postprocedure

12 Unclamp catheter tubing. To allow drainage to continue. E

13 Dispose of waste, remove apron and gloves and wash hands. To ensure correct clinical waste management and reduce risk of cross-infection (DH 2006, C).

14 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).

15 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 11.16 Urine sampling: 24-hour urine collection

Essential equipment

Clean urine collection containers (e.g. wide-necked pot)

Large urine containers (with label attached for patient details)

Appropriate documentation/forms

Optional equipment

Written patient instruction sheet

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, emphasizing the importance of not discarding any urine within the 24-hour period (provide written information if needed). 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. E

Procedure

3 Ask patient to void urine and discard this specimen. To establish the exact start time of the 24-hour period. E

4 All urine passed in the next 24 hours from this appointed time should be collected in a clean urine collection container. To ensure the specimen is