Urine may be taken from a catheterized woman for the purposes of urinalysis or infection screening, but occasionally a catheter may be inserted (often intermittent, p. 124) to obtain an uncontaminated specimen (e.g. protein urinalysis when pre-eclamptic). This section focuses on obtaining a catheter specimen from an indwelling catheter.

It is important that the following principles are applied:

• a resealing rubber ‘window’ port in the tubing

• a needleless port in some part of the tubing or drainage bag (Fig. 17.1).

In maintaining an aseptic technique, the port should be cleansed with a locally approved wipe, often 70% alcohol/2% chlorhexidine, and allowed to dry. Aseptic Non Touch Technique (ANTT) (Rowley & Clare 2011) advocates using four corners of a wipe and the middle, each for approximately 5 seconds, generating friction. This is the recommendation for intravenous ports (p. 89); it would seem sensible to apply the same practice to urinary catheter ports. Loveday et al (2014) also state that non-sterile gloves should be worn before any manipulation of a catheter.

PROCEDURE: catheter specimen of urine

• Gain informed consent, confirm identity and gather equipment:

▪ sterile specimen pot (correct one for the nature of the test required)

▪ non-sterile gloves and disposable plastic apron × 2

▪ 20 mL sterile syringe (and 25 g sterile needle if it is a resealing port, with portable sharps box)

▪ locally approved equipment wipe

▪ gate clamp.

• Ensure privacy, wash and dry hands, put on apron and gloves.

• Examine the tubing for fresh urine; if none present apply the gate clamp below the level of the port and wait a few minutes for urine to collect. Remove gloves and apron, and wash and dry hands. If urine is present proceed to taking the specimen (‘Wipe the port…’ below).

• Return to the woman, wash and dry hands, and apply apron and gloves.

• Wipe the port with the wipe for at least 20 seconds as described above and allow to dry for 30 seconds.

• Resealing port:

▪ connect the syringe and needle using an ANTT, insert the needle into the rubber port taking care not to pierce out through the other side

▪ withdraw the required amount of urine (10–20 mL usually)

▪ discard the needle straight into the sharps box.

• Needleless port:

▪ insert the syringe firmly into the port using an ANTT

▪ withdraw the required amount of urine (10–20 mL usually).

• Place urine carefully into the specimen pot. Wipe the port for at least 20 seconds with a swab as before. Dispose of syringe correctly.

• Remove the clamp.

• Remove gloves and apron and wash and dry hands.

• Label the specimen correctly and dispatch to the laboratory with the request, often within 1 hour; this will depend on the nature of the test (if delayed, refrigeration at 4°C is sometimes acceptable).

• Document the findings and act accordingly.

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