NHA Certified Clinical Medical Assistant (CCMA)Clinical Patient CareMedium

A medical assistant is instructing a patient on how to collect a clean-catch midstream urine specimen. Which of the following instructions should the MA include?

  1. ACleanse the perineal area from back to front.
  2. BBegin voiding into the toilet, then collect the middle portion.
  3. CCollect the first voided urine of the morning.
  4. DFill the collection cup completely to the brim.
Show answer & explanation

Correct answer: B. Begin voiding into the toilet, then collect the middle portion.

The 'midstream' technique involves voiding a small amount of urine into the toilet first to flush out contaminants from the urethra, then collecting the middle portion of the urine stream, ensuring a cleaner specimen.

Why the other options are wrong

  • A. The perineal area should be cleansed from front to back to avoid introducing fecal bacteria into the urine sample.
  • C. While a first morning specimen is often preferred for concentration, the key for a clean-catch is the midstream technique, not just the timing.
  • D. Collection cups usually have a fill line; overfilling can lead to spillage and contamination.

Clean-Catch Urine Collection

A method of collecting a urine sample to minimize contamination from the skin and external genitalia, typically for culture and sensitivity testing.

  • Cleanse perineal area thoroughly.
  • Void a small amount into the toilet first.
  • Collect the 'midstream' portion.
  • Avoid touching the inside of the cup.

Memory trick: Cleanse, Start, Catch, Stop!

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