Observed urine setup?

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I work in an outpatient opioid treatment clinic.  My office is moving into a new  building and we are trying to configure a bathroom setup where I can directly observe patients without actually standing in the bathroom over them, since the new bathroom is super tiny.  It’s directly beside the intake office where I would be.  I suggested a pass through in the wall that I could stand at and observe, with doors that could be closed if necessary if someone else needed that restroom.  Someone else suggested a 2-way mirror in addition to that.  
 

Anyone here in the same situation with any ideas that have been successful for your practice?

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Specializes in Psych, Addictions, SOL (Student of Life).
On 9/16/2022 at 5:58 AM, ND76 said:

I work in an outpatient opioid treatment clinic.  My office is moving into a new  building and we are trying to configure a bathroom setup where I can directly observe patients without actually standing in the bathroom over them, since the new bathroom is super tiny.  It’s directly beside the intake office where I would be.  I suggested a pass through in the wall that I could stand at and observe, with doors that could be closed if necessary if someone else needed that restroom.  Someone else suggested a 2-way mirror in addition to that.  
 

Anyone here in the same situation with any ideas that have been successful for your practice?

When I had to submit to such testing I never used a bathroom that staff at the clinic would have used. This is because there was  no running water  allowed. As demeaning it seemed at the time I entered the toilet area removed my pants or hiked my skirt to waist level did a full 360 degree turn then the opserver handed me the cup. The cup did not leave my sight until it had been placed in the split tubes and sealed for processing. The toilet tank was chained shut and there was no sink. The person observing the test put blue food coloring in the bowl. Just outside the collecting area was a sink for washing hands. I believe that if you are testing for DOT you have to have a seperate area not used by staff as there is aways a risk of contamination.

Hppy

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My office has a regular urine door that is propped open that we observe through.  and while our sink is functional, it isn’t allowed to be turned on before I have the urine in hand.  We don’t do DOT or legal chain of custody urine drug screens at my job, just point of care and occasionally send out for confirmation if there is a contested result or there is a suspicion of adulteration or substitution.  

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ND76 said:

I work in an outpatient opioid treatment clinic.  My office is moving into a new  building and we are trying to configure a bathroom setup where I can directly observe patients without actually standing in the bathroom over them, since the new bathroom is super tiny.  It's directly beside the intake office where I would be.  I suggested a pass through in the wall that I could stand at and observe, with doors that could be closed if necessary if someone else needed that restroom.  Someone else suggested a 2-way mirror in addition to that.  

Anyone here in the same situation with any ideas that have been successful for your practice?

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No, but I had to shake my head at being reminded about supervised urine screens. No other patient populace has to prove themselves as worthy of medical care.

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Specializes in PMHNP.

Is there a reason it needs to be observed?  Is this for MAT or ASAP requirements?

Our set up is just a restroom with no sink water.  There is dye added to the toilet and they are instructed not to flush.  UDS cups have a temperature strip that must be valid.  They put all their items in a locker before going in and have to pat themselves down to show everything is empty.

I don't see a benefit to observed samples if you are not doing chain of custody (and even then?).  

Feel like this is an old, outdated practice in medicine and is mainly used in corrections.

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Snowranger19 said:

Is there a reason it needs to be observed?  Is this for MAT or ASAP requirements?

Our set up is just a restroom with no sink water.  There is dye added to the toilet and they are instructed not to flush.  UDS cups have a temperature strip that must be valid.  They put all their items in a locker before going in and have to pat themselves down to show everything is empty.

I don't see a benefit to observed samples if you are not doing chain of custody (and even then?).  

Feel like this is an old, outdated practice in medicine and is mainly used in corrections.

Unfortunately, in TN the way the state guidelines for office based opioid treatment are written, it says observed drug screens. 

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Snowranger19 said:

Is there a reason it needs to be observed?  Is this for MAT or ASAP requirements?

Our set up is just a restroom with no sink water.  There is dye added to the toilet and they are instructed not to flush.  UDS cups have a temperature strip that must be valid.  They put all their items in a locker before going in and have to pat themselves down to show everything is empty.

I don't see a benefit to observed samples if you are not doing chain of custody (and even then?).  

Feel like this is an old, outdated practice in medicine and is mainly used in corrections.

Because they're assumed guilty, until proven innocent.

Demand to see a Chain of Custody? They'd just kick the patient out. It's more like parole than healthcare.

Also, remember that dipsticks and the like are a drug screen, not a test. Results are presumptive only, and need to be confirmed in a lab (GCMS)

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