Safety & Escalation Cheat Sheet updated—use the latest steps.
In House Urine Drug Screening
Secure the Collection Site: Ensure privacy and minimize the possibility of tampering by turning off water sources in the restroom, ensuring a secure toilet tank, or adding blue dye to the toilet water.
Prepare Equipment: Have the drug testing cup, any necessary labels, a timer, and gloves ready.
Verify Identity: Ask the individual providing the sample to present a photo ID.
Pre-test Instructions: Briefly explain the collection process and instruct the individual to wash their hands prior to providing the sample, according to Identify Diagnostics.
Check for Tampering: Instruct the individual to empty pockets and remove any unnecessary outer clothing to prevent potential tampering.Specimen Collection:
Open and Dispense Cup: Visibly inspect the foil package containing the cup for any signs of compromise before opening it in the individual's presence.
Collect Sample: Have the individual urinate directly into the test cup, ensuring the sample volume reaches at least the minimum level (usually indicated by a line on the cup),. A 30 mL sample is generally the minimum for standard urine drug tests.
Secure the Lid: The individual should tightly screw the lid onto the cup.
Check Temperature: Immediately after collection, check the temperature strip on the cup to ensure the sample is within the acceptable temperature range (typically 90-100 degrees Fahrenheit or 32-38 degrees Celsius). Temperatures outside this range may indicate tampering.
Activate the Test: Remove the peel-off label covering the test strips on the side of the cup.
Start Timing: Place the cup on a flat surface and start a timer for 5-7 minutes.
Read the results after the specified time according to the manufacturer's instructions, typically 5 minutes. Avoid reading results after 8 minutes, as they may become invalid. Note that the intensity of the line in the Test region does not affect the interpretation of a negative result.
Interpret Results:
Negative: A negative result is indicated by two colored lines appearing on the test strip for each drug tested: one in the Control region (C) and one in the Test region (T).
Positive: A presumptive positive result is indicated by a colored line appearing in the Control region (C) but no line appearing in the Test region (T) for the drug in question. Positive results from in-house screens require confirmation by a laboratory using methods such as GC/MS.
Invalid: If no colored line appears in the Control region (C), the test is invalid and should be repeated.
Document Results: Record the results on the appropriate form (See Below) or template, noting any discrepancies or unusual observations.
Handle Positive Results: If a preliminary positive result is obtained, send the specimen and the completed chain of custody form to an accredited laboratory for confirmation.
Chain of Custody: If following chain of custody procedures, ensure proper documentation, including labeling the specimen, sealing the container in the donor's presence, having the donor initial the seal, and tracking every person who handles the specimen.
If you are unsure on how to perform any of the steps above please do not hesitate to ask for help!
Sending Urine and Blood Specimens to The Lab
Transporting blood and urine samples from a doctor's office to a lab requires careful handling to maintain specimen integrity and ensure accurate test results.
Containers:
Blood samples are usually collected in specialized tubes with tight-fitting caps, often color-coded according to the specific tests requested.
Urine samples are collected in clean, sterile containers.
Leak-Proofing: Both containers must be leak-proof to prevent spills during transport.
Secondary Containment: The primary containers (tubes, cups) are placed inside a secondary, leak-proof container, typically a biohazard bag or other sealable, leak-proof container.
Absorbent material (like cotton wool or absorbent pads) should be placed within the secondary container to absorb any potential leaks from the primary container.
Labeling: Each container must be clearly labeled with the patient's information (name, date of birth, medical record number, etc.), the collection date and time, A biohazard label or symbol must be prominently displayed on the secondary container, and potentially the primary container if it contains bloodborne pathogens.
Any accompanying paperwork (e.g., test requisition forms/patient demographics/insurance information) should be kept separate from the primary specimen, typically in the external pocket of the biohazard bag, to prevent contamination.
Third, Rigid Container: The secondary container is then placed inside a third, rigid container, such as an insulated cooler or a Styrofoam shipper. This provides additional protection and helps maintain the required temperature during transport.
Temperature Requirements: Each type of specimen may have specific temperature requirements during transport to prevent degradation.
Most serum specimens need to be stored at 4–8°C for up to 7 days, or frozen at -20°C or lower for longer periods, and transported with frozen ice packs.
Whole blood can be transported at room temperature (20-24°C or 68-75°F) for up to 6 hours before processing, according to iMatrix Systems. However, it generally needs to be stored and transported between 2-8°C (35-43°F). Whole blood should never be frozen.
Urine samples needing centrifugation should be kept at 4°C (39.2°F).
If a frozen specimen is required (for instance, urine for certain tests), it should be immediately frozen and transported using dry ice.
Coolants: When temperature control is necessary, coolants like cold packs (refrigerated or frozen) or dry ice should be used.
Cold packs or wet ice can be used for refrigerated samples during short-term transfers.
Dry ice is used for frozen samples, placed outside the secondary container within an insulated, gas-venting container. Ensure adequate ventilation if using dry ice.
For LabCorp Specimen Collection- there are two ways to schedule;
(1) Call (800)762-4344 and reference # 19043620. Press option (2), then option (3). Follow the prompts.
(2)Click on Labcorp Link ( https://link.labcorp.com/landing), Sign in, Click the tile that says “ Specimen Pickup”, Select the correct pick up location, Click “Submit Request.
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