Urine Culture
| PATIENT INFO |
| Patient Name: |
| Medical Record #: |
| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
| Address: |
| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
| Ph: ( ) - Fax: ( ) - |
| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Urine Culture | |
| 2. | |
| 3. | |
| 4. | |
| 5. | |
| 6. | |
| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
URINE
Test Workstation :
MIC2
Specimen Type:
1.0 mL cytoscopic urine, suprapubic urine, catheter collected urine, or clean catch mid-stream urine in sterile container.
Minimum Volume:
Urine minimum volume is 0.1 mL.
Cause for Rejection:
Quantity not sufficient, improper specimen type, improper storage/transport, mislabeled, or unlabeled. Urine specimens > 24 hours. Urine specimens obtained with the same collection method within 48 hours of receipt of first specimen will be rejected as a duplicate specimen.
Storage:
Transport refrigerated required from off campus location. Upon arrival in laboratory, store refrigerated for up to 24 hours.
Availability:
Mon-Sun
Methodology:
Culture
Special Instructions:
The use of the BD C&S Preservative Plus Urine Tube is acceptable to hold the urine up to 24 hours at room temperature.
Collection variants
Clean Catch Midstream
For female patients, separate the labia and cleanse the urinary meatus with one antiseptic wipe at a time. Wipe from front to back.
For male patients, cleanse the urinary meatus with one antiseptic wipe at a time.
After the patient has started urinating, collect a small amount of urine in the specimen container.
Foley catheter
Swab the foley catheter tubing puncture port with alcohol swab. Allow to dry.
Allow the urine to collect in the tube beneath the puncture port.
Insert the needle into the puncture port.
Aspirate 5cc of urine and place in the sterile specimen container.
Collection variants
Clean Catch Midstream
For female patients, separate the labia and cleanse the urinary meatus with one antiseptic wipe at a time. Wipe from front to back.
For male patients, cleanse the urinary meatus with one antiseptic wipe at a time.
After the patient has started urinating, collect a small amount of urine in the specimen container.
Foley catheter
Swab the foley catheter tubing puncture port with alcohol swab. Allow to dry.
Allow the urine to collect in the tube beneath the puncture port.
Insert the needle into the puncture port.
Aspirate 5cc of urine and place in the sterile specimen container.
Lab/Phone:
330-543-8406
TAT:
72 hours
CPT Code:
87086
