A Foley catheter is a flexible tube inserted through the urethra into the bladder to continuously drain urine into an external collection bag. This indwelling catheter is used when a person cannot urinate normally, such as with urinary retention, during surgery, or for monitoring fluid output. When testing urine for bacterial infection or kidney function, a fresh, uncontaminated sample must be collected directly from the catheter system. This procedure ensures the sample accurately reflects the urine currently in the bladder, avoiding contamination.
Necessary Preparation and Supplies
Preparation begins with meticulous hand hygiene, washing thoroughly with soap and water or using an alcohol-based sanitizer. The correct equipment is necessary to maintain sterility and ensure the sample’s integrity. Supplies include a sterile collection container, a 10 to 30 milliliter Luer-lock syringe, and antiseptic wipes for cleaning the access port. Non-sterile gloves are needed for personal protection, along with a specialized clamp or clip to temporarily stop urine flow. Pre-printed patient labels are required to accurately identify the sample container for the laboratory.
Step-by-Step Collection Procedure
The process begins by locating the specific sample port on the catheter tubing, typically found near the junction connecting the catheter to the drainage tube. The tubing must be clamped below this sample port to allow fresh urine to accumulate. A waiting period of approximately 15 to 30 minutes is required to ensure the collected urine is newly produced by the kidneys and not stale urine, which could skew culture results.
Once sufficient urine has collected, meticulously clean the sample port by scrubbing it vigorously with an antiseptic wipe for at least 15 seconds. After the antiseptic has dried completely, insert the tip of the sterile syringe into the port. Draw a sterile urine sample (generally 10 to 30 milliliters) back slowly into the syringe using the aspiration technique. Immediately after removing the syringe, release the clamp on the catheter tubing to restore normal drainage into the collection bag.
Post-Collection Care and Sample Integrity
After collection, carefully transfer the urine from the syringe into the sterile specimen cup, avoiding contact with the inside of the cup or lid. The container must be sealed tightly and accurately labeled with the patient’s full name, date, and the exact time of collection. All used supplies, including the syringe, antiseptic wipes, and gloves, should be disposed of properly according to medical waste guidelines.
Ensuring the catheter tubing is completely unclamped is a final step to prevent urine backup. The labeled specimen is then placed into a biohazard bag for transport to the laboratory. If transport is delayed, the sample may require temporary refrigeration, as specified by protocol, to slow bacterial growth and preserve test results.
Critical Warnings and Contamination Prevention
A fundamental principle for maintaining sample integrity is the prohibition against collecting urine directly from the drainage bag. Urine in the collection bag is contaminated because it contains bacteria that have colonized the bag, leading to inaccurate culture results. Every component used, including the syringe and specimen cup, must be sterile to avoid introducing external contaminants.
If the catheter line is accidentally disconnected, both the catheter and the drainage system should be replaced immediately with a new, sterile system to minimize infection risk. If resistance is felt when aspirating urine, or if the patient reports pain during temporary clamping, the procedure must be stopped immediately. These signs indicate a potential issue, such as a blockage or bladder discomfort, requiring immediate communication with a healthcare provider.