Steps

Rationale/Points of Emphasis

1 Perform hand hygiene. Gather the necessary supplies.

Reduces transmission of microorganisms. Promotes efficient time management and provides an organized approach to the procedure.

2 Close the door to the child’s room and draw the curtains around the bed to provide privacy, as appropriate.

Provides privacy during the procedure.

3 To collect from an inline catheter port, clamp the indwelling catheter 4-6 inches below the needleless sampling port on the urine catheter tubing. Clamps need to remain in place long enough for urine to collect in the drainage tubing.

Allows urine to collect in the drainage tube. The time necessary for urine to collect may vary from child to child.

4 Establish a clean working area, by using a clean towel spread open.

Establishes a space from which to gather equipment and proceed with collection without contamination.

5 Using aseptic technique (see Figure 125-1 Aseptic Non-Touch Technique Approach), open the sterile alcohol swabs/disinfectant swabs, sterile 3- or 5-mL syringe, sterile 21- to 25-gauge needle or needleless adapter, and sterile specimen container, and place them on the towel in their packages to maintain the sterility of the supplies.

Facilitates ease of access to the equipment.

6 Don gloves.

Reduces transmission of microorganisms.

7 On the catheter tubing (for small volumes of fresh urine) or on the urine collection bag (for large volume of nonfresh urine), wipe the sampling port with friction by using sterile antiseptic swabs and allow it to air dry.

Prevents contamination of the sampling port and specimen by microorganisms and prevents introduction of organisms into the closed catheter system.

8 Withdraw urine from the sampling port by using a needleless adaptor with syringe (preferred) or a 23-or 25-gauge needle.

Allows for specimen to be obtained. Fresh urine should not be collected from the urine collection bag because that urine is contaminated and the components of the urine change when the urine has been sitting at room temperature.

caREminder

Aspirate approximately 10 mL of urine for a culture or urinalysis. Consult with the institution laboratory manual for all other exact amounts needed for each laboratory test. Many laboratories can complete the tests with very little urine collected.

9 Withdraw the needleless adaptor or needle and syringe and inject the urine directly into the sterile specimen container.

Draining the urine directly into the specimen container decreases the possibility of contaminating the specimen.

10 To collect from the urine bag for a nonfresh urine, unclamp spigot located on urine collection bag and empty urine into the specimen container. Reclose spigot when collection completed.

This will not be a sterile specimen.

11 Put the lid on the container, label the specimen, and place it in a biohazard bag.

Standard precautions.

12 Unclamp the indwelling catheter tubing.

Allows urine to flow into the drainage bag. Stasis of urine in the bladder can cause urinary tract infections.

13 Send the specimen to the laboratory immediately.

Results of the test may be altered if urine is allowed to sit for any duration.

14 Dispose of used equipment and waste in appropriate receptacle. Remove gloves. Perform hand hygiene.

Standard precautions. Reduces transmission of microorganisms.