Specimen collection is often contracted by most organizations to collecting agencies which are expected to exhibit their expertise in preserving the dignity of the specimen collection and DOT mandates particular requirements. The agencies are expected to comply with the training requirements and thus regularly update records of their certification training. It is preferable – though not compulsory- to re-train collectors usually after every 6 months in case they have not collected any specimen during that period. To ensure that changes in policies related to the job are known to the collectors, proper documentation should be carried out.
Privacy is pivotal; only donors and collection staff are allowed in the collection area, therefore collection sites are required to be protected. Proper identification and removal of external clothing should be carried out before donors enter the private bathroom to collect a specimen. Collection containers are designed to be contamination free, however due to its ability to absorb drugs from urine, polypropylene containers face lesser problems than others. Collected systematically, the specimens are identified by placing labels on the bottles to classify the urine and its date of collection. A separate container is provided by most collection kits recently and urine is transferred into the specimen bottle. The seal on the bottle also contains identification label. To ensure that the specimen are not forged, adulterated or surreptitiously diluted by the donors, the bathrooms are made free of cleaning agents by putting blue dye in the toilets and disconnecting other sources of water. Exiting the bathroom, the donors make their way directly to the collector’s counter who checks the temperature of the specimen (to certify that is ranges between 90 and 100 F) and instigates an external CCF. Completing their portion of the document, the laboratories will return the testing results on the same form; a copy of the result would be filed.
Since the collector is responsible to oversee that the specimens are not diluted, exchanged or adulterated, he has the right to ask donors to empty their pockets or do away with any object that may aid to tamper the results. He should oversee donors prior to the collection and report any suspicious behavior, for example donors concealing objects under their attires or transmitting packets, vials or similar vessels in their pockets. Such requirements are necessary because there are various products sold in small, concealed containers which can be used to manipulate urine specimen collected in the drug-testing programs (refer to Chapter 5- Adulteration). In cases of tampered evidence and in the United States Armed Forces, donors are subject to scrutiny and authentication of the specimen being collected rightfully rests in the observer’s hands.
The bottle’s label is verified after the collection by both the donor and the collector to ensure that the numbers match those on the external CCF and the bottle is covered in tamper-proof seal. Peel-off labels in most current custody forms have identification numbers which aid as tamper-resistant seal. Endorsing this label helps the donor to ensure that the identifying numbers on the bottle and the custody form match. Printed names and signatures of the collectors on the external CCF help to certify that they performed the procedure with the proper requirements. Upholding the QA process, the collecting agency should emphasize the specimen dignity; therefore it’s one of the key functions of the collect to correctly identify the specimens. Specifications in the operating procedure have several examples including: each specimen should be handled individually, the entire collection process has to be completed before the next one can start (to prevent mislabeled specimens) and that identifying numbers on the bottle labels and CCF are compared and documented.
Once the specimen is collected and sealed, the bottle of urine and the completed custody forms are placed in a shipping container by the collector; the external containers are sealed and dispatched to the testing laboratories via for mail or direct delivery. To ensure that specimens are accounted for at all checkpoints and not left unattended or lost is a key QA practice during the pre-shipping process. The specimens should reach laboratories within 2 days. Though tracking of specimen during shipment is not bound by formal legislation, many organizations employ express mail carriers with tracking mechanism to monitor the items throughout the journey.