Collecting clean-catch urine in the nursing home: obtaining the uncontaminated specimen.

Bacteriuria in incontinent nursing home residents is prevalent. It is often difficult to determine whether bacteriuria is accompanied by symptoms of a urinary tract infection, especially in cognitively impaired persons. Careful nursing assessment of the person's behavior and voiding pattern is essential and should be shared with the clinician determining medical treatment. All residents who have bacteriuria should be monitored for signs and symptoms of bacteremia. Clean-catch urine specimens are needed to guide diagnosis and treatment decisions concerning bacteriuria in the nursing home setting, and yet these specimens are difficult to obtain. The adaptations to the standard guidelines for obtaining clean-catch urine specimens that were described in this article provide nurses with a method of specimen collection that can minimize difficulty, save time, and better assure accurate results.