POLICIES AND PROCEDURES MANUAL

CLEAN CATCH (MIDSTREAM) URINE COLLECTION

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SUBJECT: CLEAN CATCH (MIDSTREAM) URINE COLLECTION

1. PURPOSE:

This policy will provide guidelines for the procedure to be used to obtain a
clean voided specimen for diagnostic purposes.

2. POLICY:

1. All laboratory orders are to be transcribed from the physician’s order onto the LAB
request form

2. Any licensed nursing employee may obtain a clean catch urine specimen
for laboratory analysis when ordered by a physician.

3. Nursing personnel, having direct or the potential for contact with exposure to
blood, body fluids, or other potentially infectious material of individuals, are expected
to practice STANDARD PRECAUTIONS according to guidelines established by the
CSH Infection Control Program. Personal Protective Equipment (PPE) and
engineering controls shall be used as needed.

4. When a urine specimen needs to be collected, nursing staff are to use the
Laminated Instruction Guide “Series I: Clean Catch Urine Specimen Collection” to
instruct individual on how to collect a urine specimen by using the midstream (clean
catch) process.

5. ALL urine specimens shall be collected by the “clean catch” process, including
specimens for Urinalysis (UA) and Culture and Sensitivity (C&S). The only
exception will be 24-Hour Urine collections.

3. GENERAL INFORMATION:

To decrease contaminated specimens, the Infection Control Committee designated

that urine specimens are to be collected by the midstream (clean catch) process. The
instructions are to be used by nursing staff to instruct individuals on how to collect a
urine specimen.
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CLEAN CATCH (MIDSTREAM) URINE COLLECTION
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1. Clean catch containers are obtained from Central Supply and have the contents
of the package listed on the outside. They are sterile unless opened or damaged.

2. The instructions for use are on the inside of the package.

3. Collected specimens are sent immediately to the designated specimen collection

site refrigerator prior to the 0800 pick-up or to the main lab. If specimens have already
been picked up from the Program specimen refrigerator. This should be done within
thirty (30) minutes of collecting the specimen.

4. During non-business hours, weekends, and holidays, collected specimens are

sent immediately to the specimen collection site refrigerator within (TBD)

4. PRECAUTIONS:

The fluid blood and moist body substances of all individuals shall be treated as
thought they were contagious. Hand hygiene before and after procedure. Wear
gloves and handle the specimen as if it were capable of transmitting disease.

5. EXPECTED OUTCOME:

1. Individual produces midstream urine specimen that is not contaminated with feces
or toilet paper.
2. Non-contaminated urine specimen obtained and delivered to contract lab in timely
manner.

6. EQUIPMENT:

1. Laminated Instruction Guide (“Series I: Clean Catch Urine Specimen Collection”)

2. Clean catch container.
3. Antiseptic solution.
4. Appropriate waste receptacle.
5. Plastic sealable specimen transport bag for lab specimen.
6. Gloves.
7. Other personal protective equipment as appropriate.
8. Completed laboratory requisition form Miscellaneous Lab slip.
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7. PROCEDURE:
NURSING ACTION
A. Check physician’s orders.
B. Hand hygiene
C. Label specimen container and lab slip
while hands are clean. Label specimen
container with date and time of collection,
individual’s name, CSH number, and unit
location. Include on lab slip individual’s
name, CSH number, unit, test requested,
nature and source of specimen, date and
time of collection, name of the ordering
physician, and physician’s diagnosis or
suspected diagnosis.
D. Identify individual by photo ID and
explain procedure to the individual.
Assess and evaluate individual’s
understanding of purpose and ability to
cooperate.
E. Have individual wash his/her hands
before, and after, procedure.
F. Instruct the male individual to expose
the glans and cleanse area around
meatus. Wash area with mild antiseptic
solution or liquid soap. Rinse area
thoroughly to remove soap
residue.
G. Allow initial flow to escape.
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KEY POINTS
A. To prevent error.
B. To prevent infection or contamination of
specimen.
C. This is recorded on Miscellaneous Lab
slip. Contract Lab requires that the source
of the specimen and physician’s diagnosis
or suspected diagnosis needs to be
identified on the lab slip, including the
name of the ordering physician.
D. Use the Laminated Instruction Guide
(Series I: Clean Catch Urine Specimen
Collection) to instruct individual on how to
collect a clean catch midstream urine
sample.
E. Reduces transmission of
microorganisms.
F. Observe technique of individual to verify
compliance with technique. The urethral
orifice is colonized by bacteria and must
be cleaned thoroughly to prevent
contamination of the urine. Antiseptic
solution can inhibit bacterial growth in a
urine culture.
G. Having the individual begin to urinate
in a bedpan, urinal, or toilet and then stop
urinating washes the urine out of the
distal urethra, reducing the risk of
collecting organisms at the urethral
orifice.
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H. Collect the midstream urine specimen.
Avoid collecting the last few drops of
urine.
I. Instruct the individual to wash hands.
J. Using a new single glove to handle the
specimen, place it into a specimen
transport bag using clean hand to handle
the bag. Follow by thorough hand
washing.
K. Place completed lab slip in pouch of
the specimen transport bag.
L. Document in IDN, lab slip, and on the
individual’s Diagnostic MAR: LAB.
Document individual teaching on the
“Wellness and Recovery Individual and
Family Health Education Record”.
M. Immediate evaluating, sorting, and
logging begin when the lab reports arrive
on the unit. Promptly report unusual test
results to physician.
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H. Assist individual as needed using
gloves. Remove gloves and wash hands
upon completion of procedure.
I. Reduces transmission of
microorganisms.
J. Outside of bag should not be touched
by the hand contaminated by specimen
prior to hand washing. Make sure that
the lid is properly screwed onto the cup to
prevent leakage and spills.
K. Send specimen in specimen transport
bag immediately to the designated
specimen collection site. The specimen
must be refrigerated immediately as the
colony count increases after 30 minutes
and contaminates may grow.
L. Staff member who collected the
specimen will record the exact date and
time the specimen was collected on the
lab slip, and the Diagnostic MAR: LAB . Its
disposition will also be reflected in the ID
notes.
M. As the lab report arrives on the unit, the
Med Room person and/or the Shift Lead is
responsible for notifying the RN of its
arrival. The RN is expected to promptly
review all incoming lab results, then date
and initial the Diagnostic MAR: LAB form.
If the results of the lab(s) are out of
therapeutic parameters, the RN shall notify
the physician of these results and reflect
this on the Diagnostic MAR: LAB form by
checking the YES box, followed by
identifying the same information in the
IDN, including action taken.
 POLICIES AND PROCEDURES MANUAL
CLEAN CATCH (MIDSTREAM) URINE COLLECTION
DOCUMENT CONTOL REVISION NO. EFFECTIVITY DATE PAGE
NO. *** ***
00 REVIEW DUE
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