Patient brings own urine sample for preoperative pregnancy testing

[DineenC]

I work at an endoscopy center. Patients who are childbearing age/ability are encouraged to consent to preoperative HCG testing. On occasion, we have patients bring in their own urine sample in from home for this. When this happens, all of my co-worker are under the assumption that this sample can not be used. They say "how can you be sure that its the patients urine". I wonder how my coworkers are sure any patients urine comes specifically from any patient, as they do not follow the patients into the bathroom to watch them provide the samples that are obtained on site. I believe that we should use these provided from home samples. First of all, many of the patients who do this state that they have some kind of anxiety issue that will not allow them to produce a sample on-site, and then end up having to sign a waiver because they can not provide the sample, and the HCG test is not done at all (how on earth is this better). Secondly, in my opinion, the sample from home is more likely to yield more accurate results as it is more likely to be from the first morning void (contains more HCG). I know that the urine should be properly stored - and that is a whole separate issue. I would like to know is does anyone have somewhere that I can reference guidelines on this from a credible organization.

[blondy2061h, MSN, RN]

Yeah no way would I use a home sample

[Zyprexa]

Reminds me of the random jar of urine (aka "Granny's Peach Tea") in Batman V Superman

[dirtyhippiegirl, BSN, RN]

My brain automatically wanders to the patient who absolutely thinks that you're going to drug test them and they care more about getting out of THAT than whether they are going to receive sedation while pregnant.

[DineenC]

Is there a credible organization that addresses this?

[blondy2061h, MSN, RN]

Would you test a blood sample a patient brought in from outside? It's better to have a waiver documented than information that is patently false and manipulated.

[MunoRN, RN]

Proper urine hCG testing is performed on the first sample after waking and the sample remains stable for a while, so unless the person can hold that first morning pee until they get to the clinic it's usually preferred to have them bring their morning sample in with them. If you want to determine is someone is pregnant at other times of day then a blood test should be done.

If the pregnancy test is optional, as described, then I'm not sure why people think someone would go through the trouble of cheating the test.

[klone, MSN, RN]

I would certainly rather test their home urine than not test them at all.

[klone, MSN, RN]

If you want to determine is someone is pregnant at other times of day then a blood test should be done..

The urine of someone more than 2 days pregnant will still show +, regardless of time of day.

[NicuGal, MSN, RN]

After going thru a pre-op for a big surgery, my blood work was done 5 days prior, I wish they could just draw a test then. After being NPO for hours, it was like squeezing a rock for liquid lol ��

But a urine from home, probably not. Although I was like, hook my IV up for a bit, then I can pee lol

[DowntheRiver]

Not always true. I've had patients that have tested positive that morning and then when they come to the clinic they test negative. And yes, we require the specimen on site, but I work in a clinical setting. If you can't produce then we draw blood and you wait for the results. In a clinic setting, this means results next day typically.

And yes, many people do think you are testing them for drugs even if you're testing for glucose, ketones, WBCs, etc. I used to do DOT physicals which required a urine specimen and people would be very weary of providing a specimen because they really thought it was another drug test.

[blondy2061h, MSN, RN]

After going thru a pre-op for a big surgery, my blood work was done 5 days prior, I wish they could just draw a test then. After being NPO for hours, it was like squeezing a rock for liquid lol ��

But a urine from home, probably not. Although I was like, hook my IV up for a bit, then I can pee lol

I had preop labs once that included an HCG. Two days later they did a urine HCG at the facility. I thankfully hadn't become pregnant in those two days.