Obtaining urine specimen from foley

[Ms.RN]

How do you obtain urine specimen from foley catheter?

My inservice/infection control nurse told us during our inservice that every time we have to obtain urine from foley, we have to insert new foley in, not just a foley drainage bag but new catheter too. I mean if patient needs urine specimen 2 or 3 times a week, we have to take old one our and insert new one, isn't that a infection issue?

When I did my clinicals in the hospital, we never had to reinsert new foley nor I was taught this way in nursing school. I was taught to clamp the foley and obtain urine specimen from the pole close to the foley catheter.

Does anyone have article or some kind of research paper that shows the proper way of doing this? Thanks

[RN1989]

I've never heard of pulling and re-inserting foleys. You clamp, wipe off the access port, withdraw, unclamp.

[CT Pixie, BSN, RN]

Just a student here but I was taught the procedure to obtain a urine specimen from a foley just as you were. Clamp tubing, From the port..wipe with anticeptic, let dry, insert new sterile needle and withdraw needed urine.

Here is a previous post from here on the way to obtain urine from foley

[snowfreeze, BSN, RN]

Where I work we use foleys with a port to take urine samples, the foley tubing is antibacterial. I clamp the tubing past the port for a period of time (depending on how much urine output this patient has), clean the port with an alcohol wipe then draw a sample from the tubing. 10cc is enough for a urine culture and basic urinalysis.

[Daytonite, BSN, RN]

What is your facility policy and procedure manual say you are supposed to do? That is what you should do.

Think about this. The specimen needs to be sterile. Maintain sterility in collecting the specimen. There are a couple of ways to collect the specimen. You can insert a sterile needle attached to a sterile syringe and withdraw a specimen from a port in the drainage tubing after swabbing with alcohol. You can also swab the tubing and catheter connection with alcohol after clamping the catheter for 30 minutes and empty the urine into a sterile specimen cup.

[Dolce, RN]

Why would a new foley need to be inserted each time? Just clamp the foley, collect the urine, wipe port with with alcohol, insert sterile needle and draw off your collection.

I had to stop a nursing student a few weeks ago from using the y-port on the foley. Don't collect urine from there--it may be surprisingly watery!

[Sam C Zacharia]

i obtain sample for culture from foley by drawing with a syringe after cleaning & drying the Y junction of the cathetr with alcohol

[SadRN2010]

I'm shocked to hear how many of you use alcohol to clean the port before withdrawing a sterile urine sample. I was taught that alcohol can alter the results, use betadine to clean port of a foley. :)

[HamsterRN, ADN, RN]

It's actually betadine that has the potential to alter the results, although it's unlikely to alter them significantly. Unlike alcohol, when betadine dries it leaves a residue that can kill bacteria when it's re-hydrated. This means that dry betadine on the port can enter the urine sample and potentially kill some of the bugs you are trying to identify. This would only alter the culture though, the esterase and WBC's would still accurately indicated if a UTI exists.

What is the rationale for changing a Foley after obtaining a urine sample?

[mblochrn]

According to current APIC guidelines, If a CAUTI is suspected, the best practice is removal of the old catheter before collecting the specimen. This is due to biofilms that may have developed on the inner or outer surfaces.

More info r/t biofilms can be found on CDC website

[lvnnars1]

What do you guys mean from the "port", are you all collecting the urine sample from the tubing connected to the drainage bag? Or the foley cath directly from the bladder?

[rkitty198, BSN, RN]

lvnnars1 said:

What do you guys mean from the "port", are you all collecting the urine sample from the tubing connected to the drainage bag? Or the foley cath directly from the bladder?

The tubing conneted to the collection bag has what is called a "safe sampling port" where you can attach a syringe to collect samples.

If you collect it from the bladder you would have to disconnect the drainage collection bag and get it from the catheter itself- which opens the patient up to infection. (when you remove the red tape from the catheter itself)