obtaining UA/C&S in LTC

[nursegreenbean]

I was just wondering what other facilities policys are regarding obtaining urine for US/C&S. I looked in my facilities policy/procedure book and it didnt have anything regarding this. I have had several nurses at my facility tell me different ways to get it and I just want to know the right way. 1st resident only uses bed pan or urinal he does not get up to use the commode. I was told by 1 nurse to get a new urinal and obtain the sample from it but another nurse said you couldn't gat it that way that he would have to be staight cath'd, 2nd resident can use a bedside commode and I was told to put a hat in it. So why could you use a new clean hat but not a new clean urinal. 3rd resident has a foley cath and i was told to hang a new bag and when there was enough in it to obtain it from the bag. When I got home i researched it and what i found was that it should have been obtained from the foleys port. So anyways when does a person have to be straight cath, can you get a sample from a hat and a urinal. I thought it was suppose to be a sterile sample so if it comes from a hat or urinal how do you make sure it stays sterile. Thanks

[RNBearColumbus, BSN]

Here's my way of determining how I'm going to go about getting a sample:

If the resident is continent and can tell me or the STNA that they need to urinate, I will go ahead and use clean catch technique and a clean hat / urinal to obtain the sample since I will be able to get the urine into the specimen cup right away.

If the resident is incontinent, and does not have a foley in, I will ask the physician or nurse practitioner ordering the UA to also order that the resident be straight cathed to obtain the sample.

Finally, if the resident has a foley inserted, I will use a clamp / rubber band to close off the tubing, let urine collect in the tubing and use a syringe to access the foley port and obtain the sample that way. ( Getting the sample from the collection bag is not really a good idea, too likely to be contaminated)

Hope this helps!

[horrorxgirl]

I always straight cath. It is a very very very rare occasion that I get a sample any other way. I've never had a sample sent back stating it was contaminated which leads to quicker treatment. It's also quicker than waiting until someone has to urinate and then being readily available right at that exact time, and then making sure that everything is nice and clean for the sample. On a busy floor it can be easy to miss opportunities like that, and it's unfair to ask them to hold it until you can get to them.

Edited to add: If the person has a foley I collect it just as the person above stated. Syringe right from the foley port.

[silverhalide]

Have a question with this -- when straight cathing to obtain the urine sample, is it recommended to have the cath go directly into the urine specimen cup or is it ok for it to still go into the sterile tray and then into the urine specimen cup?

[amoLucia]

I drain straight to the specimen cup rather than the tray. One less chance for potential contamination when you would go to pour it off.