The Right Way to Collect a Urine Specimen from a Patients with an Indwelling Catheter

Nurses General Nursing

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As someone who uses an indwelling urethral catheter for bladder management, I'm exceedingly frustrated by how few nurses (and doctors who are not urologists, for that matter) know the proper procedure for collecting a urine specimen from someone with an indwelling catheter.

I've had five orders for a UA written during recent visits to the ED and an admission for abdominal surgery. Not one of the four nurses or the ED doctor who came to collect the specimen knew the correct procedure, and only one (a marvelous RN) listened to me when I explained why the way she planned to take the sample would not yield accurate results and what needed to be done to collect a valid specimen.

So I'm curious. As a nurse, were you ever specifically taught how to collect a urine sample from patients who rely on indwelling catheters? If so, what were you taught? Did this teaching occur as this part of your nursing school curriculum or did you learn on the job from another nurse, doctor, or (gasp!) a patient?

Specializes in Med Surg.
Yeah, definitely an overreaction on the part of the OP. There is way too much to know to learn it all in nursing school, so NS teaches the basics. Much of what a nurse learns about nursing is on the job, but even after many years in the profession there is no way nurses or doctors can know everything about everything.

Agree. My wife has taught a couple of dozen nurses how to remove a below knee prosthesis. Most have no idea how or think all you have to do is give it a real hard tug.

As for the UA sample, I was taught in school the same way others have said. Drain the tube, clamp it off, draw from the port when the tube refills. Oh yeah, unclamp the tube when finished.

agree. my wife has taught a couple of dozen nurses how to remove a below knee prosthesis. most have no idea how or think all you have to do is give it a real hard tug.

as for the ua sample, i was taught in school the same way others have said. drain the tube, clamp it off, draw from the port when the tube refills. oh yeah, [color=sandybrown]unclamp the tube when finished.

oh yes please do not forget that :lol2::lol2:

also may i add do not forget to unclamp the catheter when taking the sample /flushing :lol2: " had an er nurse forget that one " i also had someone forget to deflate the bloon before trying to pull it out :eek::eek::eek: ouch !!!!!!!

I think you won but you will have to check with the OP you are the olney one who said to clear the tube frist ! ! the last person I had used the needle port but they where sucking day old urine and stuff from the tube .

:uhoh3: sputter....gasp....retch a little :D Nothing like some chunky urine for a UA !!

OH yes please do not forget that :lol2::lol2:

Also may I add do not forget to UNCLAMP the catheter when taking the sample /flushing :lol2: " had an er nurse forget that one " I also had someone forget to deflate the bloon before trying to pull it out :eek::eek::eek: OUCH !!!!!!!

Yeah, I hate when the patients start to float.....:eek:

Specializes in Peds/outpatient FP,derm,allergy/private duty.
I agree with the poster above. The fresher the better. I have even unhooked it and let it drain in a sterile cup before.

However, I do disagree with your *gasp!* about learning from the patient. In the ER, people come with all sorts of things we aren't used to seeing or dont know the exact way the patient was told it should be done, so I have no problem asking,"when you do this at your home/doctors office/other hospital, ect, how do you do it?" I think I can use my judgement to see if it's along the correct lines.

Yep. Lots of of patients have their unique "off-label" ways of doing things in home care, too. Hipcrip, why not just post what is the proper procedure in your opinion instead of creating all the suspense? You want to tell everyone why their method is wrong, with specificity?

Ohhhhh.... we're being graded....:) Then I want to clarify my rationale for not clamping the catheter.... In case I can't (couldn't) get back d/t some unforeseen situation, I don't have to worry about autonomic dysreflexia if the urine starts to back up :)

Specializes in Adult ICU.

Where I work as a tech in the ED I have put in hundreds of Foley. When inserting a catheter I always get the urine out of the port after inflating the balloon with the same syringe. If I am collecting urine from a Foley later I use alcohol swab and swap the port and get urine from there. I never get it from the bag. If a patient comes in without a port that has had the Foley for a long time I will just switch out the tubing/bag and then drain the urine into the sterile bag and vacutainer the urine from the urine cup I collect.

I was taught in nursing school to use the port, I was taught to change the bag in the ED. Some nurses try to tell me to collect old urine that "it's ok." I'm going to do the job the right way and not do short cuts because I'm not coming back to do it again when lab says the urine is not good. I do believe in fresher is better.

Specializes in Trauma Surgical ICU.

OP, I have found one of your last post regarding this very matter and I am sorry to say, but THIS is how we were taught to do it from nursing school.. You can purchase any nursing textbook, reference guide, or google the topic and you will find the same standards we have mentioned here..

As for MD's, I don't know what they are/were taught in medical school, I didn't attend hehe :) But I will have to say more research will have to be done before "best practice" is changed.

With budget cuts etc.. I really don't see many facilities removing the "old" foley, inserting a new one to get a urine sample every time one is ordered. I see the costs vs benefits issue as well as pts refusing because it can be very painful.

I wish the other posters would have asked OP what IS her way of doing this procedure correctly before answering; sometimes patients think they know IT ALL because they have had this particular condition/equipment for months; and only done it one way and will not justify any other way - so OP how do YOU do it? Than we will tell you if its correct or not.

Specializes in Med/Surg.
I think you won but you will have to check with the OP you are the olney one who said to clear the tube frist ! ! the last person I had used the needle port but they where sucking day old urine and stuff from the tube .

How could there possibly be urine in the tubing that's a day old. If that's the case, it means a) you haven't moved for an entire day and b) you're not putting out NEARLY enough urine....

How could there possibly be urine in the tubing that's a day old. If that's the case, it means a) you haven't moved for an entire day and b) you're not putting out NEARLY enough urine....

I clamp mine off in the morning before going to work and sometimes it stays clamped untell bedtime so the urine that is trapped can be really old and I have had people try to us it for a UA before .

I clamp mine off in the morning before going to work and sometimes it stays clamped untell bedtime so the urine that is trapped can be really old and I have had people try to us it for a UA before .

With what you said about the cleanliness of your collection bag and this comment, it is pretty clear to me why you are getting so many UTIs in the first place.

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