URINE COLLECTION FROM INFANTS AND CHILDREN FOR MICROBIOLOGY SAMPLE, CLEAN CATCH CLINICAL GUIDELINE. 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 Urine collection from infants and children for microbiology sample, clean catch clinical guideline.

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4.

5.

6.

7. 8.

9.

possible avoid the first urine and obtain sample whist urine is in ‘full flow.’ 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. Transfer urine into sterile collection pot, 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. 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. 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

Compliance with policy

Ward managers Ward audit and review As part of weekly safety audit schedule Reported via ward managers and review of weekly audit results a at Directorate Audit and guidelines meetings. Ward managers

Tool Frequency Reporting arrangements Acting on recommendations and Lead(s) Change in Required changes to practice will be identified and actioned within practice and 3 months. A lead member of the team will be identified to take each lessons to be change forward where appropriate. Lessons will be shared with all shared the relevant stakeholders

4. Equality and Diversity 4.1. This document complies with the Royal Cornwall Hospitals NHS Trust service Equality and Diversity statement which can be found in the 'Equality, Diversity & Human Rights Policy' or the Equality and Diversity website.

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

Urine collection in infants and children for microbiology sample, clean catch clinical guideline.

Date Issued/Approved:

March 2016

Date Valid From:

March 2016

Date Valid To:

March 2019

Directorate / Department responsible (author/owner):

Tabitha Fergus

Contact details:

01872253119

Brief summary of contents

Clear guideline for staff collecting a clean catch urine sample from an infant or child. Urine sample Clean catch microbiology RCHT 

Suggested Keywords: Target Audience

PCH

CFT

KCCG

Executive Director responsible for Policy: Date revised:

March 2016

This document replaces (exact title of previous version):

CLINICAL GUIDELINE FOR CLEAN CATCH URINE COLLECTION FROM INFANTS AND CHILDREN FOR MICROBIOLOGY SAMPLE.

Approval route (names of committees)/consultation:

Practice development forum Audit and guidelines meeting

Divisional Manager confirming approval processes

Tim Mumford

Name and Post Title of additional signatories

Not Required

Name and Signature of Divisional/Directorate Governance Lead confirming approval by specialty and divisional management meetings Signature of Executive Director giving approval

{Original Copy Signed} Name: Helen Ross-Magill {Original Copy Signed}

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Publication Location (refer to Policy on Policies – Approvals and Ratification):

Internet & Intranet

Document Library Folder/Sub Folder

Paediatrics

Links to key external standards

none

Related Documents:

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.

Training Need Identified?

No

 Intranet Only

Version Control Table Date

Version No

Summary of Changes

Changes Made by (Name and Job Title)

June 2010

V1

Initial Issue

Tabitha Fergus Deputy ward manager

March 2013

V2

Update and reformat

Tabitha Fergus Deputy ward manager

V3

Tabitha Fergus Removal of urine pad collection information Practice Development and re format. Nurse

March 2016

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 Form Name of the strategy / policy /proposal / service function to be assessed (hereafter referred to as policy) (Provide brief description): Urine collection from infants and children for microbiology sample, clean catch clinical guideline. Directorate and service area: Child health Is this a new or existing Policy? Existing Name of individual completing Telephone: 01872253119 assessment: T.Fergus 1. Policy Aim* Clear guidance for ward staff collecting samples form infants and Who is the strategy / children. policy / proposal / service function aimed at? 2. Policy Objectives* Standardised evidenced based practice. 3. Policy – intended Outcomes*

Standardised evidenced based practice.

4. *How will you measure the outcome? 5. Who is intended to benefit from the policy? 6a) Is consultation required with the workforce, equality groups, local interest groups etc. around this policy?

Audit and review

Children and families

no

b) If yes, have these *groups been consulted? C). Please list any groups who have been consulted about this procedure. 7. The Impact Please complete the following table. Are there concerns that the policy could have differential impact on: Equality Strands: Age Sex (male, female, trans-

Yes

No X X

Rationale for Assessment / Existing Evidence

gender / gender reassignment)

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Race / Ethnic communities /groups Disability -

X X

Learning disability, physical disability, sensory impairment and mental health problems

Religion / other beliefs

X

Marriage and civil partnership Pregnancy and maternity Sexual Orientation,

X X x

Bisexual, Gay, heterosexual, Lesbian

You will need to continue to a full Equality Impact Assessment if the following have been highlighted:  You have ticked “Yes” in any column above and  No consultation or evidence of there being consultation- this excludes any policies which have been identified as not requiring consultation. or  Major service redesign or development Nox 8. Please indicate if a full equality analysis is recommended. Yes 9. If you are not recommending a Full Impact assessment please explain why. No areas indicated Signature of policy developer / lead manager / director t.fergus Names and signatures of members carrying out the Screening Assessment

Date of completion and submission March 2016

1. 2.

Keep one copy and send a copy to the Human Rights, Equality and Inclusion Lead, c/o Royal Cornwall Hospitals NHS Trust, Human Resources Department, Knowledge Spa, Truro, Cornwall, TR1 3HD A summary of the results will be published on the Trust’s web site. Signed ___T.fergus____________ Date ____march 2016____________

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