In a DOT collection, the donor is always required to make an attempt to void a specimen. If thy say they cannot go right now, they are required to try anyway. Once an unsuccessful attempt is made this starts the shy bladder process.
A Shy Bladder Log is used to document the shy bladder process. When you start the Shy Bladder Log you stay on the log until it is complete. Then you go back to custody and control form.
Instruct the donor to not drink any fluids except the water provided (NO MORE THAN 40 OUNCES). A clinic employee must monitor the donor during the three-hour period or until an appropriate specimen is provided, whichever comes first. All fluids provided and collection attempts made after the initial attempt must be documented. Be prepared to stay after-hours if the three-hour interval extends beyond your shift.
Note: A refusal to drink fluids is not a refusal to test. Make a remark and proceed with the collection.
Specimens are never combined to get the 45ml needed for a successful collection. Each insufficient quantiy of specimen is discarded unless it appears to be tampered or temperatue out of range – these are packaged up with a complete custody and control form for testing at the laboratory. The second collection is performed under direct observation procedures. Both specimens are sent to the lab with one referencing the other. Also, in the remarks area write “Spec 1 of 2 – (123).” The (123) should be the specimen ID number from the second custody and control form you will be using. The specimen ID number for each collection must be cross referenced on the other custody and control form. Once the first collection is complete, you will start the second collection under direct observation. All of the information in Step 1 of the second collection will be the same as in Step 1 of the first collection, just copy it over.
At the three hour mark, if the donor could not provide a specimen, the collector notifies the DER and makes a note in the remarks section of the custody and control form. Attach the Shy Bladder Log to your collector copy so it is available upon request to the MRO or employer.
Review Shy Bladder Procedure:
- Provide instructions to donor and document
- Instruct donor to drink up to 40 oz. of fluid, reasonably distributed – Refusal to drink fluids is not a refusal to test
- Donor has 3 hours to provide a sufficient specimen
- Donor cannot leave collection site before the collection process is completed – this is a Refusal to Test
- If no specimen is provided, immediately notify the DER, mark “None-Provided” box on CCF & note on “Remarks” line that additional notes are on the Shy Bladder Log. Send the CCF copies to MRO & Employer. Keep the shy bladder log for your collection site records.