I swear I have been taught before that you can collect a urine specimen for a UA from a drainage bag (urostomy) as long as the drainage bag is brand new, and only IF it is the very first urine obtained from this bag. Is that correct? Or are we not able to do that? Can it only be obtained by clamping/drawing through the tube?
Editorial Team / Admin Rose_Queen, BSN, MSN, RN 6 Articles; 11,329 Posts Specializes in OR, Nursing Professional Development. Has 18 years experience. Oct 25, 2015 Best place to find an answer is either in your facility's policy and procedure manual or by contacting the lab running the test. All of our urine samples are drawn from the port in the tubing.
Karou 700 Posts Specializes in Med-Surg. Has 1 years experience. Oct 25, 2015 Depends on your facilities policy. We can obtain from the bag only if the foley was just inserted. Otherwise, must be drawn from the tubing/sample port. This is entirely facility and policy specific though.
KelRN215, BSN, RN 1 Article; 7,349 Posts Specializes in Pedi. Has 16 years experience. Oct 26, 2015 For just a U/A we always sent from the bag. Cultures need to be withdrawn from the sample port.
DierkyBrewster 20 Posts Oct 26, 2015 I was just curious, because to me it is almost no different than doing a clean catch sample. I had informed a family member that the R's UA came back abnormal and they were upset with me saying it was because I got the urine from the bag and "They had been trained on urostomies" and they KNOW that I can't get urine that way because the urine will always come back abnormal. I guess thats where that 3+ protein, 2+ blood, and Hi WBC count came from.
RNfaster 488 Posts Oct 29, 2015 If patient has a urostomy, e.g., ileal conduit, the stoma should be cathed for the urine sample. Even, so, many providers will say U/A results from ileal conduits are going to be abnormal. Check this out: http://www.thepathologycenter.org/uploads/PDFs/education/SpecimenUrineUrinary%20diversion.pdfExcerpt: "The skin, stoma, bag and urine in the bag are routinely contaminated/colonized with bacteria of many different types. Bacteria can grow very fast in urine (E. coli has a doubling time of 20 minutes) and this means that bacteria present low amounts which would not ordinarily be considered significant enough for microbiologic work up can within an hour or two grow up to significant numbers (104 to105) which would merit work up and reporting. Therefore suboptimal collection and transport of urine from ileal conduits can lead to false positive UA and culture results,a misdiagnosis of urinary tract infection and unnecessary treatment with antibiotics."
RNfaster 488 Posts Oct 29, 2015 I have learned that if family or the patient is questioning something, it's usually worth it to investigate further. With a Foley catheter, it's okay to take it from the sample port. Ileal conduit is another beast.
DierkyBrewster 20 Posts Oct 30, 2015 Well we appeased the family and got another sample via in and out and the results were almost identical, so she still got the antibiotics she needed. Which is the main goal.
RNfaster 488 Posts Oct 30, 2015 Interesting...I guess that might be why some of the providers I have talked to say it's not really worth it to get a sample... Initially, I learned from nursing staff about using a catheter to get the sample... Just surfing the internet, and per different institutions, there are different ways to clean the stoma before getting the sample...warm water and iodine...another sterile saline.... I wonder if there's any evidence supporting what is best. As another poster said, might be good to check your institution's policies. One thing I like about nursing is I learn stuff every day...
