contaminated urine specimen

[Spring235]

I contaminated my pt.'s urine specimen. I'm a student, I didn't think about it until AFTER clinical. I thought I was being helpful because pt. stated they had burning while urinating along with frequency. So, I alerted the nurse and I obtained a urine specimen. The patient urinated in a bedside pan but also had a small BM on the toilet paper...I don't know what I was thinking but I collected that urine that was in the bedside pan. I was driving home and I thought OMG why the heck did I collect that urine?! It was completely contaminated. Will it be obvious that a urine specimen was contaminated? I remember looking at the results at the end of the day and it showed >150 WBC, >150 RBC, and +2 bacteria, etc. Could I cause harm to my pt. if the doctor prescribed a med that was un-needed? I feel so awful......What do you all think about this scenario?

[jelly221,RN, MSN]

Let the primary nurse know! Or the charge nurse, if that nurse isn't working. They might pick up on the fact that it was contaminated if the patient's clinical S/S don't go along with the results, but regardless, you need to make sure they know. Antibiotics can have some nasty side effects, and even if the patient escapes these, unnecessary antibiotics increase the patient's risk of developing a resistant strain of a microorganism. Further, if antibiotics are started based on the urine that you collected, it might mask the actual microorganism in the urine (if there is one), causing an incorrect identification in the future. Also, we often use the same urine specimen for a culture & sensitivity if lab has enough leftover, so they might end up diagnosing the patient with a nasty UTI (e coli, enterococcus, whatever else is in the stool) erroneously.

Don't beat yourself up, everyone is human. But make sure that you do the right thing to correct your mistake and mitigate the harm that could come to the patient. That's risk management in a nutshell.

[Double-Helix, BSN, RN]

How long ago was this? If it was recent (within the past few days) you should contact the floor and let the charge nurse know. There definitely could be contamination from the bed pan or the feces that is causing a false positive on the urinalysis.

An unnecessary antibiotic probably won't harm the patient, but it can extend hospitals stay and could promote the growth of resistant bacteria. Antibiotics also have side effects which may be more prevalent depending on what other medications the patient is taking. I'm glad you recognized your mistake, now you need to take the next step and admit it for the benefit of the patient.

[Spring235]

Thanks for the replies. I did let my instructor know. She told me in that situation I could call the floor unit and let them know. The patient was already discharged.

[jelly221,RN, MSN]

Good job =) Even though the patient had already left, you did the right thing.