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PROCEDURE CHECKLIST Chapter 27: Collecting a Clean-Catch Urine Specimen Check (9) Yes or No PROCEDURE STEPS NOTE: If patient is can do self care, instructs patient in the following steps. If not, performs them for the patient. 1. Assists patient to toilet, commode, or onto bedpan. 2. Opens prepackaged kit, if available, and removes contents. 3. Washes hands and dons clean procedure gloves. 4. Instructs patient to cleanse around the urinary meatus if able; if not able, performs cleansing. Female Patients 5. Asks patient to spread her legs; washes perineal area with warm water and mild soap. 6. Opens the antiseptic towelette in the prepackaged kit. If there is no kit, pours antiseptic solution over cotton balls. 7. Cleanses perineal area in a front-to-back direction; cleanses over the urinary meatus. 8. Cleans the perineal area at least twice. 9. Uses each towelette area or each cotton ball only once. Male Patients 10. If penis is uncircumcised, retracts the foreskin back from the end of the penis. 11. Uses towelette from the prepackaged kit or pours antiseptic solution over cotton balls. 12. Grasps the penis gently with one hand; with the other hand, cleanses the meatus in a circular motion from the meatus outward; cleanses for a few inches down the shaft of the penis. 13. Cleanses around the meatus at least twice, using each area of the towelette or each cotton ball only once. For all Patients NOTE: Some lab manuals recommend rinsing the antiseptic solution from the meatus to prevent contamination of the specimen with antiseptic. 14. Removes gloves; washes hands; dons a second pair of clean procedure gloves. 15. For the patient using a bedpan, raises the head of the bed to a semi-Fowler’s position. 16. Opens the sterile specimen container; does not touch the inside of the lid or the container. 17. Holding the container near the meatus, instructs the Yes No COMMENTS Copyright © 2007, F. A. Davis Company, Wilkinson & Van Leuven/Procedure Checklists for Fundamentals of Nursing patient to begin voiding. a. For female patient: Holds the labia apart during this step (or teaches self-care patients to do so). b. For the male patient unable to assist, holds the penis. 18. Allows a small stream of urine to pass, then places the specimen container into the stream. 19. Does not let the end of the male patient’s penis touch the inside of the container; does not touch the female perineum with the container. 20. Collects approximately 30–60 mL of urine. 21. Removes container from the stream and allows the patient to finish emptying the bladder. 22. For the male patient who is uncircumcised, replaces the foreskin over the glans when the procedure is finished. 23. Carefully replaces the container lid, touching only the outside of the cap and container. 24. Cleanses the outside of the container of urine, if necessary. 25. Labels the container with the correct patient information (in many institutions these are preprinted or bar-coded). 26. Places the container in a facility specific carrier (usually a plastic bag) for transport to the lab. 27. Removes gloves and washes hands. If the specimen has been obtained from a patient on a bedpan, leaves gloves on until the bedpan has been removed, emptied, and stored properly. 28. Assists patient back to bed or removes bedpan. 29. Transports the specimen to the lab in a timely manner. Recommendation: Pass ______ Needs more practice ______ Student: Date: Instructor: Date: Copyright © 2007, F. A. Davis Company, Wilkinson & Van Leuven/Procedure Checklists for Fundamentals of Nursing