Urine Specimen Collection from an Indwelling Foley Catheter | Lecturio Nursing Clinical Skills

0:04Let's talk about the skill Collecting A Urine Specimen

0:07from an Indwelling Catheter.

0:09So, just know this slide I know looks really overwhelming,

0:12but just be really familiar with your facility protocols.

0:16Now, due to the really high quality rates, we've talked about

0:19specific units may utilize a particular protocol or criteria

0:24on how we're going to collect that urinary specimen

0:27from an indwelling catheter.

0:30So oftentimes, it's going to be driven by protocols

0:33that look like this.

0:34So now, let's take a look at our equipment

0:36on how were you get that urinary specimen.

0:39We need an alcohol swab to clean that port.

0:42We need a syringe to pull back our collection

0:45in a sterile specimen container.

0:48Now, really important,

0:50make sure you get a biohazard bag to put this in.

0:54Once you collect a specimen,

0:56there could get some things on the outside of that

0:58you want to make sure this is sealed, and contained,

1:01and labeled appropriately.

1:03Also, next, make sure the patient has a client identification

1:08label on the specimen.

1:10If we don't label it, we don't know if it's his, hers,

1:14952 room, 962s room, we're not sure

1:17and that's really important

1:19in regards to patient results and treatment.

1:22So make sure, you put a patient label on your specimen.

1:31Hey guys! Welcome to this skill

1:33urine specimen collection from an indwelling catheter.

1:38So, just know, due to CAUTI rates, or Catheter-Associated UTIs,

1:44specific units may use criteria to gather a urine specimen

1:49from a catheter that's already in dwelling.

1:52So this is going to matter

1:53with certain patient populations in cases,

1:56just be aware of their specific facility protocols

2:00that you need to follow.

2:03So let's now take a look at what we're going to need.

2:05We're going to need an alcohol swab to clean that port,

2:09we're going to need a syringe so we can pull back the urine,

2:12and also the designated specimen container

2:15that your facility uses.

2:17Also, it's a great idea to grab a laboratory biohazard bag.

2:21You want to make sure you put and secure

2:23this specimen in here.

2:25And of course, it's really important to label your specimen.

2:29That's a big deal.

2:31It's really important to get the right results

2:33with the right patient.

2:40So, before we get started,

2:42don't forget about your hand hygiene,

2:44and of course provide privacy to your patient.

2:46Now, this is something we want to explain the procedure

2:49to the patient,

2:50and why we're collecting it is a great idea.

2:53Now, of course, once we get started,

2:55you can use your bedside table

2:57and make sure you're going to place this

2:59on a clean surface.

3:02And upon collection,

3:03you want to raise the bed for an appropriate working height

3:07so you have good body mechanics.

3:09Now, since we've touched that bed,

3:11perform hand hygiene again, and don your gloves.

3:15Now's a good time to go ahead and open up that specimen container

3:19and place the lid on the table.

3:21Now, just note everything inside of that specimen container is sterile.

3:26So be conscious not to touch inside here.

3:35So now, let's talk about what we need to do to get started.

3:38We want to perform our hand hygiene and provide privacy to our patient.

3:43It's always important to make sure

3:45you explain the procedure to the patient

3:47and get your equipment ready.

3:49And as you can see here,

3:50I've already got it on a clean surface.

3:52So, make sure as well, before you start,

3:55I want to raise my patient's bed to an appropriate working height.

3:58And now, that I've touched the bed,

4:00I want to perform my hand hygiene again

4:02and put on gloves.

4:13So now, that I've done that,

4:14I also have my sterile specimen container here.

4:18We want to make sure that I go ahead and open this up.

4:21Just know that anything inside this container is sterile.

4:25So you don't want to touch the inside surface.

4:32So now, I've got this open, and I'm going to put this here.

4:40Now, if there are some extra urine in the drainage tubing, for example,

4:45we want to drain any of this staining urine

4:47from the drainage tube, down into the collection bag.

4:51Now, once we've done this,

4:52we can take those alcohol pads and disinfect that port

4:56using an alcohol swab again, and to allow it to flow dry.

5:02Now, we can connect our 10 mL syringe to the port.

5:05And then we can pull back on the plunger,

5:07and when we see fresh air in here,

5:09we can aspirate the urine using that syringe.

5:13Now, remove the syringe from the sampling port

5:16and you're going to slowly transfer the urine in the syringe

5:19into the specimen container.

5:22Now, once we've completed this, you can dispose of the syringe

5:25and secure the top of the specimen container

5:28while maintaining sterility.

5:35Okay, so once I've done this, once I get started,

5:38there may be some extra urine in the tubing itself.

5:43I want to make sure I drain any standing urine from the tube

5:46into the collection bag.

5:47And really, you're just going to use gravity.

5:50So, it had this in drop this below. So that way I can empty this tubing.

5:58Now, once I've done that,

6:00I'm going to take my alcohol swab

6:02and disinfect the sampling port here.

6:06So the sampling port just as a reminder,

6:08this is our balloon port,

6:10this is not what we're using, in this case.

6:12We are using the sampling port here

6:14and I'm going to clean it with my alcohol swab,

6:16and make sure it fully dries.

6:24Now, once I've cleaned this, and allowed this to fully dry,

6:26I'm going to connect my syringe to the sampling port.

6:31So of course, as you see that was a sterile syringe

6:33that I'm attaching.

6:35So, I'm going to take my sample port,

6:37this is going to push just nicely in here.

6:41This is called a needleless sampling port.

6:45Sometimes, you may have to have a needle to access this

6:48just know this may vary depending on your equipment.

6:51But right now, I've connected my syringe

6:53and I'm also going to make sure once fresh urine appears,

6:56I'm going to aspirate and pull back on the plunger.

6:59So, it's important to note, if it's attached to the bedsheet

7:03go ahead and take this off.

7:06And I want to make sure I clamp thoroughly here.

7:10So, I'm going to clamp

7:12and then I'm going to aspirate urine here for my specimen.

7:20Now, once I've done this,

7:21I can remove the syringe from the sampling port,

7:26and then I'm going to transfer this into the specimen container.

7:41And you may need a certain amount,

7:43so you would just repeat the process.

7:45So, once I'm done, let me go ahead and dispose of this syringe.

7:51Then I'm going to take my container, make sure I secure the lid.

8:04So, upon completing the procedure,

8:06we can label the specimen container at the client's bedside.

8:09This is a great idea to do it at the bedside.

8:12That way we can double check those patient identifiers.

8:16We want to then ensure that the specimen container

8:19gets into the laboratory biohazard bag.

8:22Now, we can discard our use supplies,

8:24put the patient back in the lowest position for safety.

8:28Remove our gloves. Perform your hand hygiene.

8:31And of course, don't forget to document your procedure.

8:35Now, when we're talking about specimens,

8:37make sure you have the urine specimen

8:39and it's transferred to the lab immediately,

8:41or stored at the facility protocol.

8:48Then I'm going to take my label.

8:50In every facility is a little bit different

8:52on what the label looks like.

8:54But you notice on this image here, there's some commonalities.

8:57You definitely need the date, especially the patient's name,

9:01and all of the different components that's on your label.

9:03So make sure that you label the specimen container at the bedside,

9:07and it may look a little something like this.

9:09Then once I've done that, here's the big kicker.

9:13Don't forget to place it into a biohazard bag,

9:17and it may look like something like this.

9:19As you can imagine with transport,

9:21there may be urine on the outside of the sample,

9:24something like that.

9:25We want to make sure that this stays secure.

9:28So I'm going to put this in my biohazard bag.

9:30We want to discard all of our use supplies.

9:34Make sure as well, before you leave the patient

9:36that you're going to make sure

9:37that patients bed is in the lowest position.

9:41Now, once we've done that,

9:43I can remove my gloves, perform my hand hygiene,

9:46and document the procedure.

9:48Now, it's important to ensure that that urine sample

9:52is transferred to the lab immediately

9:54and stored according to the facility protocols.