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
   Ensure a suitable private location.
   To maintain patient privacy and dignity. E
3. 3.Show
   Prepare equipment and place on sterile trolley.
   To prepare equipment for use. E

Procedure

1. 4.Show
   If no urine is visible in catheter tubing: wash and/or decontaminate physically clean hands with alcohol rub, put on apron and apply non‐sterile gloves prior to manipulating the catheter tubing.
   To minimize the risk of cross‐infection (NHS England and NHSI [155], C).
2. 5.Show
   Apply non‐traumatic clamp a few centimetres distal to the sampling port.
   To ensure sufficient sample has collected to allow for accurate sampling (Higgins [84], E).
3. 6.Show
   Wash hands with bactericidal soap and water, or decontaminate physically clean hands with alcohol rub and put on gloves.
   To prevent cross‐contamination (NHS England and NHSI [155], C).
4. 7.Show
   Wipe sampling port with 2% chlorhexidine in 70% isopropyl alcohol and allow to dry for 30 seconds.
   To decontaminate sampling port and prevent false‐positive results (NHS England and NHSI [155], C).
5. 8.Show
   In a needleless system: insert syringe firmly into centre sampling port (according to manufacturer's guidelines), aspirate the required amount of urine and remove syringe.
   To reduce the risk of sharps injury (European Biosafety Network [58], C).
6. 9.Show
   Transfer an adequate volume of the urine specimen (approx. 10 mL) into a sterile container immediately.
   To avoid contamination and to allow for accurate microbiological processing (PHE [190], C).
7. 10.Show
   Discard needle and syringe into sharps container.
   To reduce the risk of needle stick injury. E
8. 11.Show
   Wipe the sampling port with an alcohol wipe and allow to dry for 15 seconds.
   To reduce contamination of access port and reduce the risk of cross‐infection (DH 2007, C).

Post‐procedure

1. 12.Show
   Unclamp catheter tubing.
   To allow drainage to continue. E
2. 13.Show
   Dispose of waste, remove apron and gloves, and wash hands.
   To ensure correct clinical waste management and reduce the risk of cross‐infection (DH [48], C).
3. 14.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).
4. 15.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).
5. 16.Show
   Document the procedure in the patient's records.
   To ensure timely and accurate record keeping (NMC [165], C).