CLINICAL GUIDELINE FOR CLEAN CATCH URINE MICROBIOLOGY SAMPLE.

CLINICAL GUIDELINE FOR CLEAN CATCH URINE
COLLECTION FROM INFANTS AND CHILDREN FOR
MICROBIOLOGY SAMPLE.
1. Aim/Purpose of this Guideline
1.1 This guideline aims to provide clear and standardised guidance in obtaining urine
samples from infants and children.
2. The Guidance
Urine Collection:
• A clean catch urine sample is the recommended method
for urine collection and must be attempted for all patients.
NICE clinical guidance 54.2007
Before you start to collect the sample:
Explain procedure to child and family as relevant, and obtain informed
consent.
Clean area as follows:
Boys: Make sure the head of the penis is wiped clean with lukewarm
water.
Girls: Wipe between the labia with lukewarm water and rinse well.
When to collect a sample:
Good times to catch a sample are:
• When the child has had a bottle or a drink.
• When you are changing a nappy.
• Bath time.
• When weighing child.
Note: Have sterile foil bowl close to hand and ready to use.
How to collect a sample:
1. Place sterile foil bowl under the child’s genital area. If child is potty
trained it may be helpful to place the sterile bowl into a potty and collect
the sample in this.
2. An older child may be able to urinate directly into the container.
3. If possible a mid stream sample is best, the first urine when the child
begins to urinate may be contaminated with bacteria from the skin. If
Clinical Guideline for clean catch urine collection in infants and children for microbiology sample.
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possible avoid the first urine and obtain sample whist urine is in ‘full
flow.’
4. If parent/carers collecting sample ensure they are educated to use
sterile bowl correctly. E.g. not to place fingers on rim of bowl. Use
gloves if necessary.
5. Transfer urine into sterile collection pot from PHLS, using appropriate
personal protective equipment. If using a red top pot with Boric Acid,
ensure you fill to the line with urine. A silver top pot must be used if you
have insufficient sample for a red top pot. Complete investigation form
and send to relevant laboratory.
6. Document in patient’s notes/care profile that sample has been taken
including method obtained, date and time sent in compliance with
RCHT trust standards for documentation and sample collection.
If a clean catch sample is unobtainable:
• Other non-invasive methods such as urine collection pads
should be used (see Clinical Guidelines for Urine Pad
Collection in Infants and Children.) It is important to follow
the manufacturers’ instructions when using urine
collection pads.
• Cotton wool balls, gauze and sanitary towels should NOT
be used in infants and children.
• When it is not possible or practicable to collect urine by
non-invasive methods, catheter samples or suprapubic
aspiration (SPA) should be used.
• Before SPA is attempted, ultrasound guidance should be
used to demonstrate the presence of urine in the bladder.
NICE clinical guidance
54.2007
PLEASE NOTE:
•
•
Urine collection bags may still be used where large amounts of urine are required
for other non microbiology investigations.
Urine samples must not be collected when a patient has confirmed diarrhea unless
specifically requested. This can lead to contamination of the sample.
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3. Monitoring compliance and effectiveness
Element to be
monitored
Lead
Tool
Frequency
Reporting
arrangements
Acting on
recommendations
and Lead(s)
Change in
practice and
lessons to be
shared
Correct collection procedure
W ard managers and audit staff.
Audit and practice observation.
Annually.
Audit and guidelines departmental group.
Lead nurse and relevant ward managers/ clinical staff.
Risk management and lead nurse/ ward managers.
Possible wording to use for this column.
Required changes to practice will be identified and actioned within
6 months. A lead member of the team will be identified to take
each change forward where appropriate. Lessons will be shared
with all the relevant stakeholders
4. Equality and Diversity
4.1. This document complies with the Royal Cornwall Hospitals NHS Trust service
Equality and Diversity statement.
4.2. Equality Impact Assessment
The Initial Equality Impact Assessment Screening Form is at Appendix 2.
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Appendix 1. Governance Information
Document Title
Clinical guideline for clean catch urine
collection in infants and children for
microbiology sample.
Date Issued/Approved:
22 March 2013
Date Valid From:
22 March 2013
Date Valid To:
22 March 2016
Directorate / Department responsible
(author/owner):
Tabitha Fergus Child Health
Contact details:
01872 25 2008
Brief summary of contents
Clinical guidance for preparing and
obtaining, sending and documenting clean
catch urine samples in infants and children.
Includes alternate clinical options.
Urine collection
Child health
Microbiology
Child
Infant
RCHT

Suggested Keywords:
Target Audience
Executive Director responsible for
Policy:
Frances Keane
Date revised:
March 2013
This document replaces (exact title of
previous version):
Approval route (names of
committees)/consultation:
CFT
Clinical guideline for clean catch urine
collection in infants and children for
microbiology sample. June 2010
Child Health audit and guidelines group
Lead Nurse
Practice development group
Paediatric consultants
Divisional Manager confirming
approval processes
Sheena W allace
Name and Post Title of additional
signatories
Not Required
Signature of Executive Director giving
approval
Publication Location (refer to Policy
on Policies – Approvals and
Ratification):
PCT
{Original Copy Signed}
Internet & Intranet
Clinical Guideline for clean catch urine collection in infants and children for microbiology sample.
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 Intranet Only
Document Library Folder/Sub Folder
Paediatrics
Neonatal
Links to key external standards
NICE Clinical Guidelines 54. Urinary Tract
Infection in Children. August 2007.
BMJ. Home collection of urine for culture from
infants by three methods: May 2000.
Nursing Times. Urine Collection in infants and
children. Feb 2008.
Alder Hey Children’s NHS. Clean Catch Urine
Collection.
Related Documents:
Training Need Identified?
No – revised document.
Version Control Table
Date
June 2010
March
2013
Versio
n No
Summary of Changes
Changes Made by
(Name and Job Title)
V1.0
Initial issue.
Tabitha Fergus .
deputy ward manager
V2.0
Update and re format.
Tabitha Fergus .
deputy ward manager
All or part of this document can be released under the Freedom of Information
Act 2000
This document is to be retained for 10 years from the date of expiry.
This document is only valid on the day of printing
Controlled Document
This document has been created following the Royal Cornwall Hospitals NHS Trust
Policy on Document Production. It should not be altered in any way without the
express permission of the author or their Line Manager.
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Appendix 2.Initial Equality Impact Assessment Screening Form
Name of service, strategy, policy or project (hereafter referred to as policy) to be
assessed: clinical guideline for clean catch urine collection in infants and children for
microbiology samples.
Directorate and service area: child health Is this a new or existing Procedure? existing
Name of individual completing
Telephone:01872 252008
assessment: Tabitha Fergus
1. Policy Aim*
Clear and standardised guidelines on urine collection in
infants and children for microbiology sample.
2. Policy Objectives*
Assist practitioner in obtaining sample using correct method.
3. Policy – intended
Outcomes*
Best practice.
5.
How will you
measure the outcome?
audit
5. Who is intended to
benefit from the Policy?
Service users and all involved staff
6a. Is consultation
required with the
workforce, equality
groups, local interest
groups etc. around this
policy?
Yes
b. If yes, have these
groups been consulted?
Yes.
c. Please list any groups
who have been consulted Paed consultants. Audit and guidelines group. Practice
about this procedure.
development group. Senior nursing staff.
*Please see Glossary
7. The Impact
Please complete the following table using ticks. You should refer to the EA guidance notes
for areas of possible impact and also the Glossary if needed.
•
•
•
Where you think that the policy could have a positive impact on any of the equality
group(s) like promoting equality and equal opportunities or improving relations
within equality groups, tick the ‘Positive impact’ box.
Where you think that the policy could have a negative impact on any of the equality
group(s) i.e. it could disadvantage them, tick the ‘Negative impact’ box.
Where you think that the policy has no impact on any of the equality group(s) listed
below i.e. it has no effect currently on equality groups, tick the ‘No impact’ box.
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Equality
Group
Age
Positive
Impact
x
Negative
Impact
No
Impact
Reasons for decision
Paediatric guideline
Disability
x
Religion or
belief
x
Gender
x
Transgender
x
Pregnancy/
Maternity
Race
x
Sexual
Orientation
x
Marriage / Civil
Partnership
x
x
You will need to continue to a full Equality Impact Assessment if the following have
been highlighted:
• A negative impact and
• No consultation (this excludes any policies which have been identified as not
requiring consultation).
8. If there is no evidence that the policy
promotes equality, equal opportunities
or improved relations - could it be
adapted so that it does? How?
Full statement of commitment to policy of
equal opportunities is included in the policy
Please sign and date this form.
Keep one copy and send a copy to Matron, Equality, Diversity and Human Rights,
c/o Royal Cornwall Hospitals NHS Trust, Human Resources Department, Chyvean
House, Penventinnie Lane, Truro, Cornwall, TR1 3LJ
A summary of the results will be published on the Trust’s web site.
Signed ________________T. Fergus________________________
Date ________________14.3.13_________________________
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