What is the procedure for collecting a urine sample from a patient with an indwelling urinary catheter (IUC)?

From the Guidelines

To collect a urine sample from a patient with an indwelling urinary catheter, clinicians should obtain the urine culture specimen after changing the catheter and after allowing for urine accumulation while plugging the catheter, and urine should not be obtained from the extension tubing or collection bag. When collecting a urine sample, it is essential to follow a sterile procedure to prevent contamination and ensure accurate results. The procedure involves gathering necessary supplies, including sterile gloves, alcohol or chlorhexidine swabs, a sterile syringe, a specimen container, and labels.

Steps for Collection

• Explain the procedure to the patient and provide privacy
• Wash hands thoroughly and put on sterile gloves
• Locate the sampling port on the catheter tubing, clean it thoroughly with an alcohol or chlorhexidine swab, and allow it to dry completely
• Using a sterile needleless syringe, insert the tip into the sampling port at a 90-degree angle and aspirate the required amount of urine (usually 10-20 mL)
• Transfer the urine to a sterile specimen container without contaminating the inside of the container or lid
• Label the specimen immediately with the patient's information, date, time, and collection method
• Transport the sample to the laboratory within 30 minutes or refrigerate it if there will be a delay, as recommended by 1 and 1.

Key Considerations

• The most recent and highest quality study, 1, emphasizes the importance of obtaining the urine culture specimen after changing the catheter and allowing for urine accumulation while plugging the catheter
• Avoid collecting urine from the extension tubing or collection bag, as this can lead to contamination and inaccurate results, as noted in 1 and 1
• The use of sterile gloves, alcohol or chlorhexidine swabs, and a sterile syringe is crucial to prevent contamination, as highlighted in 1
• Refrigerating the specimen if transport to the laboratory will be delayed is also recommended, as stated in 1 and 1

From the Research

Procedure for Collecting a Urine Sample from a Patient with an Indwelling Urinary Catheter (IUC)

To collect a urine sample from a patient with an indwelling urinary catheter, the following steps can be considered:

• The connection between the catheter and the urinary drainage system should not be broken except for good clinical reasons 2
• When a break in the system is necessary, it is essential to follow proper catheter care procedures to minimize the risk of infection 2, 3
• The use of a sterile closed urinary drainage system is recommended to reduce the incidence of bacteriuria 2, 3
• The vacuum tube technique or the injector technique can be used to collect a sterile urine specimen from the catheter, with the vacuum tube technique potentially reducing minor adverse events related to spillage/leakage of urine 4

Key Considerations

• The duration of catheterization is a significant risk factor for infection, and proper catheter management is crucial to prevent urinary tract infections 2
• Catheter care, including cleansing of the perineum and meatus, should be performed regularly to prevent infection 2
• The selection of the appropriate catheter material and size can benefit catheter care and prevent complications such as encrustation 5