Assessment
6
STEP 4: When Should A Diagnostic Test Be Sent For A
Potential UTI?
➤ Clinicians must consider both clinical findings and diagnostic test
results when evaluating a resident for a potential UTI.
➤ Urinalysis and urine cultures should only be sent for residents who
meet clinical criteria for UTI (as described in above-mentioned
clinical algorithms).
➤ Urinalyses and urine cultures should not be sent as a test-of-cure for
asymptomatic residents.
STEP 5: What Are The Best Methods For Urine Collection?
In absence of a urinary catheter:
➤ A voided midstream or clean catch specimen is ideal.
➤ In men, cleansing the meatus is recommended prior to urine
collection.
➤ Women who are unable to provide a good quality voided specimen may
require in and out urinary catheterization.
➤ For men unable to provide a voided specimen, temporary use of
a condom catheter, in the range of 30–120 minutes, may permit
collection of a good quality urine specimen. [Ouslander JG et al.
Arch Intern Med. 1987 Feb;147(2):286-8]
In presence of a urinary catheter:
➤ Urine samples should not be obtained from a urine collection bag
connected to an indwelling catheter (including a suprapubic catheter)
unless a new catheter (along with a new collection bag) was inserted
immediately prior to sample collection.
➤ In residents with urinary catheters present for over two weeks, the
catheter should be replaced, or discontinued altogether if no longer
needed, prior to collecting a urine specimen.
➤ When a urinary catheter has been in place for less than 2 weeks,
a decision to obtain a urine sample from the sampling port of the
existing catheter or to remove the catheter before obtaining a urine
sample should be made on a case-by-case basis. Clinicians should
consider potential clinical benefits and risks of removing and, if
necessary, replacing urinary catheters present for less than 2 weeks
as part of the evaluation for residents with suspected CAUTI.
