2. Specimen Collection
Clinic staff are exposed to urine, blood, and OPIM
(other potentially infectious materials) regularly.
Proper safety, technique, and transport methods
must be observed when handling potentially
infectious material for the following reasons:
Proper safety protects staff from transmission of
pathogens.
Proper technique protects collected specimens from
contamination.
Proper transport methods ensure viability of
specimens after collection.
3. Urine Collection – Safety Guidelines
Urine can transmit bacteria that colonize the urinary
tract and bladder, such as N. gonorrhoeae
(gonorrhea) and C. trachomatis (chlamydia).
To protect against these diseases, as well as to
minimise risk of specimen contamination, the
following PPE must be worn when collecting and
handling urine.
Face Shield
Disposable Gloves
Gloves must be changed between patients
PPE used in urine collection is considered
biohazardous, and is to be disposed of accordingly.
Urine collection cups and straws may have needles,
which are used to fill vacutainers. Exercise caution
when handling these devices to avoid needlestick
injury.
4. Urine Collection - Midstream Clean Catch Technique
It is important that the inside of the container and the cap not be touched or
come into contact with any parts of the body, clothing, or external surfaces.
The patient should first wash their hands with soap and water.
The collection cup should not be opened until just before
urinating.
The patient should then clean the genital surrounding the
urethra with a provided antiseptic wipe.
Male patients should be instructed to clean the head of the penis
with a circular motion.
Female patients should be instructed to hold the labia apart, and wipe
from front to back.
Once sterilised, the patient begins urinating into the toilet.
After portion of the urine has been voided, the urine cup is placed
into the urine midstream, then removed and quickly covered
once ¼ to ½ full.
Clean the outside of the cup with antiseptic wipes and label with
the patient name and date of birth.
5. Urine Collection – Catheter Technique
Most catheters have ports which can be
connected to a syringe for urine collection.
Adapters with needles can also be attached to
the catheter that allow vacutainers to be filled
directly.
Sterilise the port with antiseptic wipes.
If urine flow is insufficient, clamp the line
beyond the port so that urine can
accumulate in the line.
Attach syringe and draw urine, then fill a
collection cup with the collected urine.
Clean the outside of the cup with antiseptic
wipes and label with the patient name and
date of birth.
Urine from the collection bag is unsuitable
for testing due to high concentration.
6. Urine Collection – Aliquoting
If your collection cup has an integrated needle:
Place the cup on a flat surface.
Peel back the protective label on the cover and press the collection tube downward
onto the needle until full.
Remove the tube and cover the needle port with the label.
Place labeled tubes in a specimen pouch with requisition information and
refrigerate immediately.
If your collection cup does not have an integrated needle:
Place the cup on a flat surface, and remove the cover.
Place the transfer straw in the cup and press the collection tube downward onto the
needle at the top of the straw.
Place labeled tubes in a specimen pouch with requisition information and refrigerate
immediately
If the specimen tube is not evacuated for automatic filling:
Use a sterile disposable pipette to transfer urine, rather than pouring the entire
collection cup.
7. Urine Collection – Transport Media
Grey Top
Contains a preservative mixture
Suitable for:
Urine Culture & Sensitivity ONLY
Check the tube label to ensure that it is not a blood glucose tube
Striped Red/Yellow Top
Contains preservative mixture
Suitable for:
Urinalysis ONLY
Yellow Top
Does not contain preservative.
Suitable for urine tests such as:
Urinalysis
UA w. Reflex Microscopy
Urine chemistry tests (Drug/Alcohol, Chloride, Sodium, etc.)
Check the tube label to ensure that it is not a blood ACD tube
9. Blood Collection – Safety Guidelines
When working with blood, extreme caution must be exercised.
An open wound (such as a needlestick) or exposed mucous
membranes (such as the eyes) provides an entry point for
bloodborne pathogens such as HIV and hepatitis.
To protect against these diseases and others, the following PPE
must be used when collecting blood and handling implements
that have come in direct contact with blood.
Face Shield
Disposable Gloves
Adapters and needles with locking safety caps
PPE and gauze/wipes used in blood collection are considered
biohazardous, and are to be disposed of accordingly.
Sharps used in blood collection must be disposed of in a
designated sharps container.
10. Blood Collection – Venipuncture Technique
Get supplies and containers prepared and readily available beforehand.
Locate the medial cubital vein, visible anterior to the elbow.
Clean the site with antiseptic or alcohol wipes in a circular motion, with enough pressure to remove
surface dirt. Palpate the area if necessary to gauge vein position and depth.
Apply a tourniquet 5cm – 10cm (2in – 4in) medially from the intended site, and secure with a
simple overhand knot.
The tourniquet must not be tied for over 1 minute, as it alters blood molecule concentration.
Hold the needle at a 5° angle (nearly flush with the skin) with the bevel facing upward, and
smoothly insert the needle into the vein.
If using a “butterfly” collection kit, hold the needle by pinching the wings together.
A small “flash” chamber located at the base of the needle will fill with blood on a successful
puncture.
Hold the needle steady with one hand, and pierce cap of the collection vacutainer with the free
needle to begin collection.
Remove the tourniquet once blood flow is established.
Fill blood tubes in the proper order (see next slide).
Once all required tubes have been filled, apply slight pressure to the puncture site with gauze and
smoothly withdraw the needle. Cover any exposed needles with the attached plastic safety caps.
Butterfly needles may have a plastic sheath that slides down past the “wings” to cover the
needle.
If the first stick is unsuccessful, new needles must be used for subsequent attempts.
Do not attempt a fourth stick if three attempts fail. Call another phlebotomist to attempt the draw.
11. Blood Collection – Transport Media
Centrifuge gold and green tubes after
collecting blood to separate cells from the
plasma/serum and prevent hemolysing.
Hemolysing refers to the blood cells
rupturing, which clouds the
serum/plasma and alters solute
levels.
Red tubes contain silica to promote
clotting, and will automatically separate on
their own.
Do not centrifuge blue, navy, lavender, or
yellow tubes, as they are used for cell count
and coagulation tests: the centrifugal
forces can rupture cells.
