Procedure:
- Enter the patient room, check for scene safety, and ensure the scene is safe to approach.
- Protect the privacy and dignity of the patient by closing curtains, windows and doors.
- Perform hand rub using the seven steps of hand hygiene recommended by WHO.
- Introduce yourself as ‘name of candidate’ an attending nurse.
- Obtain patient information, including name, date of birth, Hospital number and confirm details with ID tag.
- Assess the patient’s current condition and comfort level.
- Explain the purpose of the procedure: collecting a urine sample from the catheter for culture.
- Inquire about the need for a chaperone (usually not required).
- Ask about allergies and pain.
- Inform the patient about the procedure duration and offer assistance if needed.
- Confirm the non-painful nature of the procedure, explaining the urine withdrawal process as 10 ml of urine would be withdrawn from the sampling port using a 10/20 ml syringe
- Assemble necessary items, and assure the patient of assistance if needed by using the call bell.
Required Articles:
– Syringe (10ml or 20ml)
– Universal specimen container
– Disinfectant wipes
– Chlorhexidine wipes (black)
– Sharps container
– Non-traumatic clamp (if required)
– Microbiology bag (if required)
– Lab form (if required)
- Put on apron and gloves after performing hand rub.
- Confirm cleanliness of the trolley with the examiner.
- Clamp the urinary catheter a few cm distal to the sampling port. Tell patient if any discomfort or fullness of bladder he should call you to unclamp the catheter in normal scenario.
- Perform hand washing using WHO-recommended seven steps and dry.
- Assemble required items in the kidney tray or trolley as stated.
- Approach the patient, confirm comfort, and proceed with the procedure.
- Wear gloves, place an incontinent pad under the sampling port, and wipe the port for 30 seconds.
- Open the syringe, withdraw urine, and demonstrate to the examiner.
- If using a needle and syringe, follow proper insertion and withdrawal techniques.
- Open the sample bottle, pour urine without touching, close the bottle, and place it in the bag.
- Dispose of the used syringe in the kidney tray or clinical waste.
- Wipe the port again with an alcohol swab and let it dry.
- Remove the incontinent pad and discard it.
- Unclamp the catheter.
- Discard gloves into the waste and needle and syringe into the sharps container (if used).
- Inform the patient that the procedure is complete and inquire about comfort.
- Explain the next steps, such as sending the sample to the laboratory or refrigerating it.
- Provide the call bell to the patient for assistance.
- Retrieve the trolley, discard waste, clean it, and prepare for the next use.
- Fill out the culture form, document the procedure, and observe the colour and nature of urine.
- Open the curtains and perform a final hand washing before leaving the room.
Pitfalls:
– Failure if the sample is taken from the incorrect port (leg bag emptying port or water balloon port).
Conclusion:
Emphasize the importance of stating the condition of the urine, unclamping the catheter, and wiping the sampling port twice. Documentation is not necessary as per the pre-documented scenario.
Things to Note:
- Scene safety
- Privacy
- Hand hygiene (Verbalize)
- Purpose of visit
- Explain procedure & gain consent
- Validate the articles
- Hand hygiene (Verbalize)
- Ensure no visible urine in the tube
- Hand hygiene, apron, and gloves
- Clamp and ensure enough urine collected
- Change apron, gloves, and hand hygiene
- Clean the collection port
- Collect urine (needleless or syringe and needle)
- Transfer it to the container
- Discard the needle and syringe into the sharps container if required
- Re-clean the collection port
- Unclamp
- Discard apron and gloves
- Communicate, educate, comfort, and provide the call bell
- Conclusion statements
ROLE PLAY
Nurse: Good day, Pratima. I’m here to gather a urine sample from your catheter. Is it convenient for us to proceed at this moment?
Pratima: Yes, it’s fine.
Nurse: Excellent. I’ll prepare the necessary equipment for the procedure. Before I go, do you need anything or are you comfortable?
Pratima: I’m fine, thank you.
Nurse: Great. Here’s the call bell. If you need assistance, just press the button.
Nurse: Assessor, may I confirm that this tray has been cleaned with soap and water after its last use?
Assessor: Yes.
Nurse: Perfect. Here’s the universal container (sample bottle) intact and in date, alcohol wipes intact and within date, and a 10ml syringe for specimen withdrawal. The non-traumatic clamp may already be attached to the catheter.
“Hello again, Pratima. Are you in a comfortable position?”
Pratima: Yes.
Nurse: Alright. Can I proceed with the sample collection?
(Perform hand hygiene, apron, and gloves)
Nurse: May I raise your clothing slightly? (Moves the cloth upward to expose the collection port)
“Now, I’ll clamp the catheter and wait a few minutes for the urine to collect.”
(Changes apron and gloves)
“I’ll now clean the sample port with an alcohol wipe for 30 seconds and let it dry for another 30 seconds. Assessor, I assume there’s enough urine in the catheter.”
“Now, I’ll insert the sterile syringe into the sample port at a 90-degree angle (or needle at a 45-degree angle) and withdraw 10 ml of the specimen. I’ll transfer the sample from the syringe to the specimen bottle without touching the edges. And close the lid.”
Nurse: Pratima, I’ve collected 10 ml of urine from your catheter. I’m going to unclamp the catheter and clean the sampling port for another 30 seconds. After that, I’ll send the sample to the lab immediately. Do you have any concerns or questions?
Pratima: No.
Nurse: Alright, Pratima. I’ll be around for a bit. If you need anything, press the call button, and I’ll come to assist you.
Conclusion Statements
Nurse: Assessor, I’ve collected the urine sample and will send it to the lab right away. Before sending, I’ll ensure that the container is labelled correctly and then send it to the microbiology lab. I will then discard the used items and make them ready for next use
Thank you
