PROCEDURE CHECKLIST

Chapter 31, Skill 31-06: Obtaining a Urine Specimen From an Indwelling Catheter

Check () Yes or No

PROCEDURE STEPS YES NO COMMENTS

1. Gathers needed supplies: sterile 10-mL
syringe, sterile noncoring blunt needle or
needleless access device, (if unavailable a sterile
22-gauge needle may be used) sterile specimen
cup, alcohol wipes, clean gloves.
2. Follows the “Initial Implementation Steps.”
3. Clamps the tubing below the level of the port
for 15 to 30 minutes and allow urine to collect in
the tubing above the clamp.
4. Dons clean gloves and opens the specimen
cup without contaminating. Cleans the port on
the tubing with alcohol and allows it dry.
5. Using aseptic technique, inserts the blunt
needle or 22-gauge needle into the port at a 45°
to 90° angle and pulls the plunger back slowly
and steadily. Withdraws between 5 and 8 mL of
urine for an adequate amount of urine for testing.
6. Holds the syringe over the specimen cup and
carefully injects the urine into the cup using
aseptic technique. Replaces the lid.
7. Disposes of the needle and syringe in the
sharps container immediately and unclamps the
catheter tubing.
8. Follows the “Ending Steps.”
9. Labels the specimen cup and places it in a
biohazard specimen bag and transports to
laboratory or specified area.
10. Documents procedure, amount and
appearance of specimen, and that specimen was
sent to laboratory.

Recommendation: Pass _____ Needs more practice _____

Student: Date:

Instructor: Date:

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