Urinalysis Collection Odyssey House of Utah

Transcription

1 Urinalysis Cllectin Odyssey Huse f Utah

2 This guide will teach yu the fllwing: Prper Urinalysis Cllectin Techniques Maintaining the cllectin site Yur respnsibilities as a trained UA Tech Hw t prperly label the cllected sample Hw t prepare samples fr shipment t the labratry Hw t stre and secure cllected samples When and hw t prperly dcument results Urinalysis 1/11 2

3 URINALYSIS COLLECTION The Wh, When, What, Where, and Hw WHO Any Odyssey Huse staff wh have cmpleted the Urinalysis (UA) Technician Certificatin Curse and have passed the cmpetence assessment with satisfactry marks are cnsidered qualified t perfrm urinalysis cllectin with clients. WHEN Each facility has UA cllectin times that are tailred t fit their unique schedules. Clients are made aware f the designated schedule, and will cme t the identified cllectin site as instructed. WHAT Here are sme basic definitins yu will need t knw when perfrming UA cllectin (pay attentin, yu will be quizzed n this): Urinalysis: The chemical analysis f urine t determine the presence f substances. Cllectin Cup: The receptacle used t cllect the urine sample. Urine Dipstick: A chemically treated strip f paper sensitive t varius parameters when dipped in urine. This strip underges a clr change when substances are detected. Cmmnly referred t as a dip test. Direct Observed Cllectin: A UA Tech, f the same gender as the client, is required t directly mnitr the client while prviding the urine sample. Direct bservatin is required fr all clients at Odyssey Huse t ensure they are nt able r attempting t manipulate the sample. Adulterants: An additive causing an undesirable effect in sample cllectin. Shy Bladder : When a client is unable t prvide a sample either under demand r when smene is nearby during the attempted urinatin (see instructins belw). Materials: Single use plastic cllectin cntainers: Each cllectin cntainer must be individually sealed with a tamper evident system (e.g., in a sealed plastic bag, shrink wrapped, r anther easily visible tamper evident system) and graduated with markings clearly shwing the vlume (e.g., 30mL, 45mL). Tamper evident label: The cllectin cntainer has tw tamper evident labels that are used t seal the cntainer and identify the client. Leak resistant plastic bags: The cllectin cntainer is first placed in an individually sealed bag, and then multiple sealed bags will be placed in a larger leak resistant bag tgether. Nte: the Parents, Adlescent, and YSC facilities wh use Glbal Drug Testing d nt need t use the individual sealed bags. All sample cntainers can be placed in the large bag that is prvided by Glbal. Absrbent material: The absrbent material is placed with the cllectin cntainers inside the leak resistant plastic bag in case a bttle leaks during shipment. The U.S. Urinalysis 1/11 3

4 Pstal Service and ther express carriers require the use f absrbent material when shipping bilgical materials. Shipping cntainers: Bxes r bags used t transprt specimens t a labratry must be securely sealed t prevent the pssibility f undetected tampering. It is nt necessary t use a shipping cntainer if a curier hand delivers the sealed leak resistant plastic bags cntaining the cllectin cntainers directly frm the cllectin site t the labratry. WHERE Urinalysis cllectin must always be cnducted in a designated restrm within each facility. This site must have all necessary persnnel, supplies, equipment, and supervisin t prvide fr the prper cllectin f urine samples. During scheduled urinalysis, the restrm is t remain under cnstant surveillance by staff t ensure clients are nt able t tamper with specimens after cllectin r prvide access t items that culd be used t adulterate r dilute the specimen. HOW: Urinalysis Cllectin By fllwing these steps, yu will help prvide clients with accurate testing and results. BEFORE YOU DO ANYTHING! Make sure yu leave all distractins at the dr! It is critical fr yu t stay fcused n the task at hand. Step 1: Prepare the Cllectin Site Assemble supplies and remve any sap, cleanser, disinfectant r ther ptential adulterants that culd be used by clients t tamper with the sample. Secure items that culd be used t cnceal adulterants (e.g. false ceilings, ledges, trash cans, twel dispensers). Always wear dispsable glves during UA testing and when handling the cllectin cntainers nce they are filled. Step 2: Verify Client Identity and Cllect Infrmatin Allw the client t select a cllectin cntainer and fill ut the identifying infrmatin and date n the cntainer label. Verify that the identifying infrmatin matches that assigned t the client. Step 3: Cllect Urine Sample Direct the client t perfrm the fllwing steps: Raise clthing, revealing their midsectin and rtate their bdy fr inspectin f any attached devices (adult clients nly) Fill the cllectin cntainer until it is at least half full D nt flush the tilet (ensure any tampering devices r liquids were nt dispsed f in the tilet during the sample cllectin) Secure the lid, ensure it is prperly clsed, and place the tamper evident label ver the cntainer s that the cntainer can nt be pened withut destrying the seal Have client initial the label nce attached Fllwing these steps, the client may nw flush the tilet Step 4: Take Pssessin f Cntainer and Perfrms Dip Test (if required) Ensure the cntainer is at least half full and inspect fr any signs f adulteratin. If perfrming a dip test, refer t instructins utlined belw. Urinalysis 1/11 4

5 Step 5: Prepare fr Strage/Shipping Cmplete staff prtin f the label by signing initials. Place the individual cntainer inside the apprpriate puch cntaining absrbent materials and seal bag. Place the single bagged cntainer in the larger bag with the remaining sealed cllectin cups. Ensure yu d nt leave the samples un attended. **Nte** The Parents, Adlescent, and YSC facilities wh use Glbal Drug Testing d nt need t use the individual sealed bags. All sample cntainers can be placed in the large bag that is prvided by Glbal. Step 6: Stre Prperly Adult, OP, Trans: Urine samples must be stred at rm temperature and in a lcked lcatin that prhibits unauthrized access r pprtunities t tamper with the cntainers until shipment. Parents, Adlescent, YSC: Urine samples must be stred in a refrigeratr if testing urine sample fr alchl. Sample must bee kept in a lcked lcatin that prhibits unauthrized access r pprtunities t tamper with the cntainer until pick up. HOW: Instant Result Dip Testing Each prgram has different rules arund when t use an instant result dip test with a client. Depending n which prgram yu are wrking at, make sure yu fllw these steps t ensure yu get an accurate reading frm the test. TESTING PROCEDURE Remve the dip test frm the fil puch ensuring the test has nt expired and is at rm temperature. Remve the plastic cap frm the device t reveal sample pads (dn t discard the cap). Dip revealed pads int urine sample fr a minimum f secnds until urine is seen wicking int the reading zne. Make sure each pad is dipped int the urine t the level f the wavy lines withut tuching the plastic card. READING RESULTS Results must be read at 5 minutes (d nt interpret results after 4 hurs as false results may ccur). Test is NEGATIVE if any visible line in the test (T) area is present. Even a faint line, indicates a negative result. Test is POSITIVE if the test (T) line is nt present. This area must be snw white t indicate a psitive result. Test is INVALID if the cntrl line (C) is nt present. If this ccurs, repeat the test using a new device. If the prblem persists, infrm supervisr. Urinalysis 1/11 5

6 HOW: Dcumentatin Cnfirmed psitive results frm a labratry must be recrded in the client file. Senir staff cllect urinalysis results frm utside labs and will place dcumentatin in the client s file if necessary. If yu are perfrming an instant dip test and the strip has a psitive r invalid reading, yu will need t phtcpy the instant dip test (with the cap n), place dcument in the client file, and prepare sample fr shipping t receive a cnfirmatin analysis frm an utside lab. Make sure that the shipment is received by the utside lab within the 24 hur windw befre the sample expires. HOW: Shy Bladder If a client tells staff, upn arrival at the cllectin site, that he r she cannt prvide a sample, staff must still begin the cllectin prcedure regardless f the reasn given. The client is instructed t engage in minutes f physical activity t encurage the need urinate, r until the client is able t prvide a sufficient urine sample, whichever ccurs first. Instruct the client t let yu knw when he r she is able t prvide a sufficient quantity f urine. Be sensitive t hw frequently yu ask a client t attempt t prvide a specimen. The client must remain under direct bservatin f staff t prevent the client frm pssibly cmprmising the cllectin prcess. If the client refuses t attempt t prvide a specimen r leaves the cllectin site befre the cllectin prcess is cmpleted, the cllectr must discntinue the cllectin, recrd a refusal t test and immediately ntify the manager n duty. If the client is unable t prvide a sufficient vlume f urine, discntinue the cllectin, and ntify the manager n duty f a ptential shy bladder situatin. HOW: If an Identifying Label Breaks If the tamper evident label des nt adhere prperly t the cllectin cntainer (e.g., due t misture, temperature, specimen bttle material) r is accidentally brken r damaged during the cllectin prcess, fllw these steps: Apply the unacceptable label t the bttle, and apply a secnd, separate tamper evident label t seal the specimen bttle. Initial and date the seal. Ask the client t initial the seal. IF YOU HAVE ANY QUESTIONS AT ALL, CONTACT YOUR SUPERVISOR IMMEDIATELY References: 1. Quest Diagnstics 2. Redwd Txiclgy 3. Glbal Drug Testing Labs Urinalysis 1/11 6