Pre‐procedure

ActionRationale

1. 1.Show
   Introduce yourself to the patient, explain and discuss the procedure with them, and gain their consent to proceed.
   To ensure that the patient feels at ease, understands the procedure and gives their valid consent (NMC [165], C).
2. 2.Show
   Fully explain the steps of the procedure.
   The patient needs to fully understand the procedure in order to avoid inadvertent contamination of the specimen and optimize the quality of the sample (Higgins [85], E).
3. 3.Show
   Ensure a suitable private location.
   To maintain patient privacy and dignity. E

Procedure

1. 4.Show
   Ask patient to wash hands with soap and water.
   To reduce the risk of cross‐infection (NHS England and NHSI [155], C).
2. 5.Show
   If practitioner's assistance is required: wash hands with bactericidal soap or decontaminate physically clean hands with alcohol rub and put on apron.
   To prevent cross‐contamination (NHS England and NHSI [155], C).
3. 6.Show
   Ask the patient to part the labia and clean the urethral meatus with soap and water, 0.9% sodium chloride or a disinfectant‐free solution.
   To optimize general cleansing and minimize contamination of the specimen with other organisms. E

   Disinfectant solutions may irritate the urethral mucous membrane (Higgins [84], E).
4. 7.Show
   Use a separate swab for each wipe and wipe downwards from front to back.
   To prevent cross‐infection and perianal contamination (Weston [255], E).
5. 8.Show
   Ask the patient to begin voiding first stream of urine (approx. 15–30 mL) into a toilet or bedpan while separating the labia.
   To commence the flow of urine and avoid contamination of the specimen with naturally occurring micro‐organisms and/or flora within the urethra (PHE [190], C).
6. 9.Show
   Place the wide‐necked sterile container into the urine stream without interrupting the flow.
   To prevent contamination of the specimen and to ensure the collection of the midstream urine, which most accurately represents the urine in the bladder (PHE [190], C).
7. 10.Show
   Ask the patient to void her remaining urine into the toilet or bedpan.
   For patient to comfortably continue passing urine (PHE [190], C).
8. 11.Show
   Allow patient to wash hands.
   To maintain personal hygiene. E

Post‐procedure

1. 12.Show
   Label sample immediately and complete microbiological request form (including relevant clinical information, such as signs and symptoms of infection, and antibiotic therapy).
   To maintain accurate records and provide accurate information for laboratory analysis (NMC [165], C; Weston [255], E).
2. 13.Show
   Dispatch sample to laboratory immediately (within 4 hours) or refrigerate at 4°C.
   To ensure the best possible conditions for microbiological analysis and to prevent micro‐organism proliferation (PHE [190], C).
3. 14.Show
   Document the procedure in the patient's records.
   To ensure timely and accurate record keeping (NMC [165], C).