Collection of specimen for Urine culture

Defintion of the urine culture

• Collection of a small sample of urine (30 to 60 ml) for detecting the presence and
growth of microorgnisms in the sample.
 Purpose of the urine culture

1. To culture pathogenic microorganisms present in the urine.

2. To determine antibiotic sensitivity of the pathogens in the urine.
 Articles
1. Sterile urine container
2. Laboratory form
3. Soap and water
4. Bed pan (for non-ambulatory patient)
SL Nurses action Procedure Rational
No
1 Check the physician’s order and identify patient. Helps to understand
purpose of procedure
for the patient

2 Assess the patient’s mobility status and activity Determines the level
tolerance to use the toilet facilities of assistance required

3 Explain procedure to patient including reason for Contaminated urine

4 Wash hands and don gloves if nurse is to perform
procedure
5 Provide privacy by closing curtains and/or door. Privacy allows patient
to relax and reduces
embarrassment.

6 Instruct patient to cleanse the perineum Female:Washe

the urethral meatus and surrounding area with soap
and water.
Male:Hold the penis with one hand and cleanse the
end of penis moving from center to outside using soap
and water.
For helpless patients:The nurse should provide
hygienic perineal care.
7 Assist bedridden patient on to bed pan
8 Instruct to open specimen container and place cap Contaminated specimen will
with sterile nside surface up and not to touch lead to inaccurate reporting
inside of container and lid. of culture and sensitivity.

9 Instruct ambulatory patients to: Female:Sit with Prevents contamination of

legs separated on toilet container rom outside.

Male:Sit down to control splashing.

10 I nstruct patient to direct the first and last part of Prevents contamination of
the urine stream into the toilet or bedpan, the specimen with skin flora
collect the middle part of
the stream into the sterile container. (Midstream
sample)
11 Replace cap securely on specimen container, Prevents transfer of
cleanse any urine from external surface of microorganisms to others
container and place container in plastic bag
or in the designated place.

12 Remove bedpan (if applicable) and assist patient Promotes relaxing

to comfortable position enviornment

13 Label specimen and send to laboratory with Prevents inaccurate

completed requisition form. identification that could
lead to errors in diagnosis
and therapy.

14 Remove gloves and dispose in proper receptacle Reduces transmission of

(if used for bed-ridden patient) and wash hands microorganisms.
14 Transport urine specimen to laboratory within Bacteria grow
15 minutes or refrigerate immediately. quickly in urine and
specimen should be
analyzed immediately
to obtain correct
results.

15 Record in the nurses’ notes the time of urine Documents

collection a nd any other observation. implementation of
physician’s order.
 SPECIAL CONSIDERATIONS

1. Patients who are catheterized should have the specimen withdrawn using a
sterile needle and syringe from the catheter’s sampling port. Clamp the collection
tube for about 30 minutes before taking sample.

2. Urine specimen must be transported to the laboratory promptly. If not cultured

within 30 minutes of collection, urine must be refrigerated and culture done within
24 hours.

3. About 30 minutes prior to collecting the specimen, patient may be encouraged

to drink fluids unless contraindicated.
Collection of 24hours Urine
 Defintion of collection of urine specimen for 24 hours

Collection of urine specimen for a period of 24 hours without any spillage or

wastage.
 Purposes

1. To detect kidney, liver and cardiac conditions.

2. To measure total protein, creatinine, electrolytes,17 ketogenic steroid, oxylate,
porphyrins, drugs , vitamins, VMA,minerals, hormones etc.
 Articles
1. Clean container with preservative, of not less than 3 liters capacity with label,
obtained from the laboratory (biochemistry).
2. Urinal or kidney tray to collect urine at each voiding.
3. Appropriate laboratory form, duly filled.
Procedures
SL Nursing actions Rational
No
1 Check the physician’s order and nursing care Obtains specific
plan instructions/information

2 Identify the patient Ensures that right

procedure is performed on
the right patient
3 Explain to the patient, the purpose of procedure Gains patient’s consent and
and, that all urine for the full 24 hours must be co-operation
saved
4 Instruct the patient to void at the time set to Ensures that urine collected
begin the procedure. E.g: at 6.00 a.m. Discard is produced within the
this specimen. 24 hours of testing
Record in Nurses’ Notes, the time when
collection began
 collection will
accommodate
Measure and pour all the subsequent voidings into the all the
5 container variables in
body chemistry
within a
representative
period

6 Collect the final specimen at exactly the same time the

patient voided 24 hours earlier. E.g: 6.00 a.m. the following
day
7 Send the container with urine to laboratory when the
collection is over, with requisition forms
8 Record in the Nurse’s notes time of
completing the collection and despatching
the urine to the lab

9 Clean , disinfect and replace the kidney tray or

urinal if they are reusable.
contd.,
• If a culture specimen is required – use sterile containers, get midstream specimen
or catherized specimen in case of urine specimen. Avoid collecting specimen
during menstruation. The inside of the container should not be contaminated
with the fingers of the nurses or clients before or after collecting the specimens.
The lid of the container should be removed and placed in such a way that the
inner surface should not be contaminated. Open the container just before
collecting the specimen and close it immediately after collecting the specimen.
 Defintion of Throat swab Culture
• A throat culture is a microbiological procedure for identifying disease-causing
bacterial organisms in material taken from the throat.
• A throat swab will capture the causative organism in most cases and the culture
will allow the specific organism to be grown in the microbiology laboratory under
certain conditions. The bacteria can then be identified .
 Purposes
1- identify the specific bacterial organisms that are causing a sore throat or throat
infection
2- a correct diagnosis is important to prevent unnecessary use of antibiotics for
viruses that do not respond to them.
3- the bacteria identified are used to determine antibiotic sensitivity, allowing
physicians to select the most appropriate and effective antibiotic to treat a specific
infection.
4 -It is common for physicians to order culture and sensitivity tests at the same
time. ( c/s test )
Procedure
• Check the physician,s order
• Identifly the patient
• Explain the procedure
• Wash hand
 Specimen Collection Obtaining for Throat Culture
• Instruct the patient to tilt head backward.
• Ask patient to open mouth and say “ah.”
• If pharynx is not visualized, depress tongue with tongue blade and note inflamed
area of pharynx and tonsils.
• Insert swab without touching lips, teeth, tongue, or cheeks.
• Gently but quickly swab tonsillar area side to side, making contact with inflamed
or purulent sites.
• Carefully withdraw swab without striking oral structures; immediately place swab
in culture tube and crush ampule at bottom of tube.
• Securely attach properly ,completed label and requisition slip to side of specimen
container.
contd.,
• Rub the swab up and down the back of the throat and against any white patches
in the tonsillar area.
• Avoid the tongue and the cheeks.
• Replace the swab in the transport tube .
• Seal tube tightly and label with patient’s information, and date .
• Send the specimen to the laboratory .
• Gargling to clear the throat or treatment with antibiotics will affect culture results
and may make identification of the bacteria impossible. The patient should not
gargle immediately before the swab.