IU Health Bloomington
IU Health Urgent Care and Occupational Health
Urine Drug Screens

Policy Statement:
It is the intent of the IU Urgent Care clinics and The Center for Occupational Health to correctly collect urine drug screens following legal regulations and to provide the patient with optimal service.

Objective:
To correctly collect urine drug screens following legal regulations and provide optimal customer service.

Implementation:
Unauthorized personnel shall not be permitted in any part of the collection site where urine specimens are collected or stored. Only the collection person may handle specimens prior to securing in the appropriate containers for shipment to the lab.

1. Verify the donor’s identity by driver’s license or other approved photo ID, or by the employer’s representative. If the donor has a scheduled appointment time and fails to arrive on time, contact the employer for guidance.
2. Collect from only one person at a time. The collection procedure is considered complete when an individual urine specimen bottle has been sealed and initialed, the urine custody and control form has been executed, and the donor has departed the site.
3. Have the donor remove any unnecessary outer garments; i.e., coats or jackets, and leave purses or briefcases with these outer garments. The donor will be asked to empty pockets while the collector looks for material, which could be used to adulterate the specimen.
4. Have the donor wash and dry their hands prior to urination. The donor shall remain in the presence of the collection site person and have no access to any water, soap dispenser, cleaning agent, or any other material, which could be used to adulterate the specimen.
5. Have the donor select a drug collection kit and open it. The individually wrapped specimen bottle(s) should not be opened until the donor returns from voiding.
6. The donor should be allowed privacy while urinating. The toilet tank shall contain a bluing agent so that adulteration of the specimen is not possible. The donor must not flush the toilet until he/she has handed the specimen to the collection person.
7. If the urine specimen is out of the temperature range, immediately notify the Company. If the Company is unable to be reached, another specimen shall be collected with the use of a witness. Acceptable range is 90-100° F.

Single Urine Specimen:

• The specimen container should be filled with a minimum of 20 ml of urine for a single specimen collection.
• If the donor is unable to provide 20 ml of urine, have the donor drink a small amount of water (not more than 40 ounces) and provide a new specimen. Discard the original insufficient specimen.
• Upon receipt of the collection container form the donor, the collection person reads the temperature indicator strip on the collection container side and records the temperature in the designated area of the Custody and Control Form (CCF). Acceptable range is 90-100° F.
• Have the donor initial and date the tamper-evident tape. In full view of the donor, seal the bottle with the cap and tamper-evident tape from the Custody and Control Form.

Split Urine Specimen (DOT):

• Have the donor collect a minimum of 45ml of urine in the collection container provided. Upon receipt of the collection container from the donor, the collection person reads the temperature indicator strip on the collection container side and records the temperature in the designated area of the Custody and Control Form. Acceptable range is 90-100° F. In the presences of the donor, pour a minimum of 30 ml of the specimen into one bottle and a minimum of 15 ml of the specimen into the second bottle. (If greater than 45 ml is provided, split the remainder between the two bottles.)
• If the donor is unable to provide 45 ml of urine, have the donor drink a small amount of water (not more than 40 ounces) and provide a new specimen. Discard the original insufficient specimen.
• In full view of the donor, tightly secure the specimen bottle cap. Have the donor initial and date the tamper-evident tapes. Place the tape across the top of the cap and down the sides of the bottle.

EScreen:

• Register patient in eScreen computer, following the on screen directions.
• DOT drug screens follow the Split Urine Specimen (DOT) guidelines.
• Have the donor collect a minimum of 45 ml of urine in the collection container provided. Upon receipt of the collection container from the donor, the collection person reads the temperature indicator strip on the collection container side. Acceptable range is 90-100° F. At the same time checking the specimen for adulterants.
• If the donor is unable to provide 45 ml of urine, have the donor drink a small amount of water (not more than 40 ounces) and provide a new specimen. Discard the original insufficient specimen.
• In full view of the donor, tightly secure the specimen bottle cap. Have the donor initial and date the tamper-evident tapes. Place the tape across the top of the cap and down the sides of the bottle.
• Print COC forms to be signed by patient and collector
• Dismiss patient
• Place specimen in the reader and proceed with test.
• Computer will notify you to Discard specimen or Send to Lab
• If send to lab, follow Transport of urine to lab guidelines.
• If Discard, urine is disposed of in biohazard trash.

Transport of urine specimens to the laboratory:

• Place specimen bottle(s) inside the inner compartment of the clear plastic bag. Seal this bag by first exposing a thin line of adhesive near the top of the bag; press the bag sides together.
• Place the Custody and Control Form inside the outer side pouch of the bag (this prevents potential leakage from the specimen bottle(s) onto the CCF). Bagged specimens shall be placed directly into a secure bag for delivery.