Random Drug Screens

[Saxynurse]

Here is the short questions: Once you obtain the urine for your randoms do you test it in house or send it off?

Long version: We test in house with intergrated EZ split kit with adulteration. Test results are available within minutes. Once we have a positive we have to send it off to labcorp for further confirmation? Anyway, my concern is that Fedex does not always pick up the urine sample the same day. Will the bacteria in the urine cause positive to come back negative-meaning change the results previously read from my cup?

What does your company do for random drug screens?

[Rbeck911, BSN, RN]

We also test in house. If we have a non-negative drug screen (legally compliant reference) we sent them to an occ health clinic to provide another sample.

Sending off the same sample doesn't really do anything for you as far as third party verification. The employee can always file wrongful termination and accuse the collector of adulterating the sample or mixing up the urine. If you are trying to protect your company from wrongful termination suits, use a simple in house instant read, and send non-negatives to a clinic to provide a secondary sample collected by an unbiased third party. It is best practice in our field.

Regarding the 'shelf life' of urine, contact the lab that verifies your samples. That is information that they should have readily available.

[Saxynurse]

So if the urine is initialed and seal by the donor can they still sue for wrongful termination?

[Rbeck911, BSN, RN]

Anyone can sue for anything. It depends on your process really, in how well that protects you. Is the associate ever separated from the sample before it is sent out? If so, his initials mean nothing, technically. Unless he follows that sample all the way until it is sealed and placed in the mail, there is always the possibility that it was adulterated.

As far fetched as it may seem, it happens. People sue for ridiculous things. And whether or not they have a good case is inconsequential. By the time that case is thrown out, your companies name was in the paper as being sued, your methods have been called into question, and a lot of money was spent fighting off the case, or money was spent to settle out of court (which doesn't technically clear your name at all in the court of public opinion, especially if non disclosure was signed). So, again, best practice is let a third party handle it. If he gets a lawyer and the lawyer sees that a third party administered the test, he probably wouldn't even take the claimants case.

[Saxynurse]

So what type of industry do you work for? I do not know of any occupational nurses!!! I work at a factory where they make heating/AC coils.

[abrucke]

I've done randoms both ways. It depends on the employers preference as well as the employers substance abuse policy. You can use a rapid screen and split and send only non-negatives to the lab. Candidates are then sent home until the MRO process is completed. Or you can automatically split all samples and send them all to the lab and wait on the results. Bacteria usually do not change the drug metabolites in the urine but you always have to option to take your specimen to a FedEx drop box which is what I do.

[katkonk, BSN, RN]

I just saw your post, as I haven't been on here for a long while. I completely disagree with Rbeck911. If you follow a strict chain of custody procedure with a COC form, with the urine sealed in the bag and the Lab COC copy in the proper place in the bag, and the seals over the top of the urine specimen container when you sealed the specimen with the employee's initials, then you are good. The employee is ALWAYS separated from the specimen once it is sealed! That is procedure. You do not have to send to an outside provider, who will then only send it out to a lab for confirmation. If you use an instant test, it is easiest to have the type that the urine remains in the same container, it offers a good seal against leaks, you seal/initial with the employee, put it in the bag, and send the whole thing off. If the seals across the top of the container are broken, the lab will not process it. The employee would have no case, as the protocol is foolproof if followed exactly. Only if there is an error in documentation or sealing would it be disputable. If you have an instant test, you can also always pour into a split specimen Labcorp or other lab tubes, and do the same seal, initial, etc. and send out as a split. I see no advantage at all to sending to an occ health provider that will only charge you more. And yes, the urine will keep overnight with no problems. I've done drug testing for quite a few years.

[Rbeck911, BSN, RN]

To each their own.