opnavinst 5350.4 d - Navy Medicine - U.S. Navy

OPNAVINST 5350.4D
4 Jun 09
f) Premise codes need not be explained on chain of
:l~stody form. Should circumstances require more identification,
include doc~lmentation with shipment to NDSL.
( - Attach gum label to body of bottle (this step may be
~iccompl~sl-led after sample has been collected, in which case
iabel must be attached to bottle in the presence of the member
aroviding the >~rine) .
5. J?!: will maintain a urinalysis ledger documenting all
- -2st
c specimens with the following identifying information:
!:, Date of collection (YYYY/MMM/DD).
I Batch number.
1 : Specimen number.
3 Member's social security number.
(? Testing premise identifier.
:ti Signature and printed name of observer.
I signature of member.
i~ Identification of new batch and specimen numbers if
.~ciminlstrar:vely changed for any reason, signature and printed
.lame 2f ind:vidual making change, and signature and printed name
I!- N; tness.
. 'JP(' shall ensure each specimen is collected under direct
~uservdt ion of a designated individual (observer) of the same
qender as t h member ~ providing the sample. Observer will sign
lrlnalys~s Ledger certifying the specimen bottle which contains
lrine provlcled by the member was not contaminated or altered.
)bser~er shall not handle the bottle unless UPC is performing
iuties of observer, in which case UPC must maintain direct
:uscody of all samples while observing.
Whenever there are more than two individuals
jrov~diny ,lrine samples, commands shall have an observer and
JPC. ;*lhere there are two or less individuals providing urine
-amples commands may have UPC act as observer as well, providing
Appendix B to
Enclosure (2 )