Urine Collection Methods in Children: Which is the Best?

Urinary tract infection is one of the most common bacterial infections in infants and young children. There are 5 collection methods commonly used to obtain a urine sample from an infant or small child: suprapubic aspiration, urethral catheterization, clean catch void, urine collection bag, and urine collection pad. Although invasive, suprapubic aspiration and urethral catheterization are less likely to cause contamination of the specimen. When deciding which method to use, providers must take into consideration the clinical presentation of a child as well as presenting and past medical history, while weighing benefits versus risks.

Urinary Management With an External Female Collection Device.

BACKGROUND: Strategies to decrease use of female indwelling urinary catheters and catheter-associated urinary tract infections are challenging due to the limited availability of proper fitting external collection devices. Female urinary incontinence predisposes the skin to potential pain, itching, burning, infection, or pressure injuries. CASE STUDIES: This article discusses 3 patients' trajectory of care with use of an external female urinary collection device. All of these females were incontinent of urine after the indwelling urinary catheter was removed and managed with an external female urinary collection device. CONCLUSIONS: The use of an external female urinary collection device is a feasible alternative to an indwelling urinary catheter as well as managing urinary incontinence.

Urinary Sample Collection Methods in Ileal Conduit Urinary Diversion Patients: A Randomized Control Trial.

PURPOSE: The purpose of this study was to compare bacteriological urinalysis findings using 3 urinary sample collection methods (clean stoma catheterization, urine dripping from the stoma, urine collected from the clean urostomy pouch) in ileal conduit urinary diversion patients. DESIGN: Randomized controlled trial. SAMPLE AND SETTING: Twenty-seven patients with ileal conduit urinary diversion from an outpatient urology clinic were enrolled; 9 patients were seen twice, for a total of 36 subjects and comparisons. METHODS: Data were collected during a clinic visit by a trained research nurse. Patients were randomized into 2 groups: group A had the first urine sample collected by clean stoma catheterization, followed by sample collection by urine dripping from the stoma; group B had the first urine sample collection by urine dripping from the stoma, followed by sample collected by clean stoma catheterization. All patients had a third urine sample collected from a factory-clean urostomy pouch. Bacteriological urinalysis findings were compared among methods. Descriptive analyses were summarized using mean, percentage, and frequency. The mean ages of the patients between the groups were compared with the t test. Other between-group comparisons were performed using the Fisher exact test. Urinary culture finding differences among the same patients were evaluated using the McNemar test. Sensitivity and specificity of the different urine sample collection methods were calculated assuming urine sample collection by catheterization as a reference method. RESULTS: Uropathogen bacteria were detected in urinary culture in 16 of 36 samples (44%) collected by clean stoma catheterization, 15 of 36 samples (42%) collected by urine dripping directly from the stoma, and 13 of 35 samples (37%) collected from the clean urostomy pouch. Significant differences among the urine collection methods were not detected. Assuming catheterization as the most reliable method of sample collection, the sensitivity and specificity of the urine dripping from stoma collection method were 81.3% and 90.0%, respectively. The sensitivity and specificity of the urostomy pouch collection method were 73.3% and 90.0%, respectively. Among the same patients, there were no significant differences in the incidence of uropathogen bacteria when clean stoma catheterization was compared with urine dripping from the stoma and urostomy pouch methods. CONCLUSION: This study provides clinically relevant information regarding urine collection methods in ileal conduit patients. Urinary sample collection by urine dripping directly from the stoma or collected from a clean urostomy pouch provided similar uropathogen bacteria findings compared with sample collection by clean stoma catheterization.

Does Suprapubic Stimulation in Infants Facilitate Collection of a Clean Catch Urine Specimen?

Review of recent evidence with translation to practice for the advanced practice nurse (APN) role is presented using a case study module for "Faster Clean Catch Urine Collection (Quick Wee Method) From Infants: Randomised Controlled Trial." This prospective study enrolled 344 infants between 1 and 12 months of age seeking care in an emergency department with a complaint that led to the ordering of a clean catch urine specimen. Use of the Quick Wee procedure yielded clean catch urine specimens without the use of an invasive procedure. Variables of interest were time to specimen collection and patient and provider satisfaction with procedure. Study subjects in the intervention group voided spontaneously within 5 min more often than subjects in the usual care group. This study highlights the important role of the APN in ordering clean catch urine specimen collection and avoidance of invasive procedures.

Recogida de urocultivo por sondaje vesical en niños: una observación sistemática / Coleta de urocultura por sonda vesical em criança: uma observação sistemática / Collect of uroculture by urinary catheter in child: a systematic observation

La infección urinaria se caracteriza por la invasión de microorganismos en el tracto urinario, siendo una de las patologías más frecuentes en todos los grupos de edad, especialmente en niños. El urocultivo se considera el método estándar-oro para el diagnóstico de laboratorio, ofreciendo un alto valor predictivo positivo, si se garantiza una técnica aséptica durante la recolección. El estudio de tipo evaluativo, prospectivo y cuantitativo, tiene por objeto comparar los resultados de los urocultivos por sondaje vesical recogidos por enfermeras del Ambulatorio y Enfermería de un Hospital Universitario Pediátrico teniendo en cuenta el material y la técnica utilizada en el procedimiento.La población de estudio consistió en 12 enfermeros, 4 residentes y los resultados de 300 muestras de cultivos de orina en el período junio-agosto de 2012. Los datos fueron recolectados a través de la observación sistemática y la documentación técnica. Los resultados mostraron una mayor contaminación del procedimiento en la enfermería (13,3%) que en el Ambulatorio (1,3%), donde se utilizó kit específico de urocultivo (AU)

A infecção urinária se caracteriza pela invasão de microrganismos no trato urinário, sendo uma das patologias mais frequentes em todas as faixas etárias, principalmente, em crianças. A urocultura é considerada o método padrão-ouro de diagnóstico laboratorial por oferecer alto valor preditivo positivo, se garantida uma técnica asséptica durante a coleta da urina. O estudo do tipo avaliativo, prospectivo e quantitativo objetivou comparar os resultados das uroculturas por sonda vesical coletada por enfermeiros do Ambulatório e Enfermaria de um Hospital Universitário Pediátrico, considerando o material e a técnica utilizada no procedimento. A população estudada foi composta por 12 enfermeiros, 4 residentes de enfermagem e pelos resultados das 300 amostras das uroculturas no período de junho a agosto de 2012. Os dados foram coletados mediante observação sistemática e técnica documental. Os resultados apontaram maior contaminação do procedimento na Enfermaria (13,3%) do que no Ambulatório (1,3%), onde se utilizou kit específico de urocultura

Urinary tract infection is characterized by invasion of microorganisms in the urinary tract, one of the most frequent pathologies in all age groups, especially in children. The uroculture is considered the gold standard method of diagnosis for offering high positive predictive value, if guaranteed aseptic technique during the urine collected. The assessment study, prospective and quantitative aimed to compare the results of urine cultures for catheter collected by nurses in the clinic and infirmary of a University Hospital Pediatric, considering the material and the technique used in the procedure. The study population consisted of 12 nurses and 4 nursing home residents and the results of 300 samples of uroculture in the period June-August 2012. Data were collected through systematic observation and technical documentation. Results showed higher contamination procedure Infirmary (13.3%) than in the Clinic (1.3%), which we used urine specific kit (AU)