CLINICAL GUIDELINE FOR URINE SAMPLE COLLECTION FROM INFANTS AND CHILDREN USING URINE COLLECTION PAD. 1. Aim/Purpose of this Guideline 1.1. To provide clear guidance on best practice in obtaining a urine sample from infants and children. 2. The Guidance THESE GUIDELINES MUST ONLY BE USED FOLLOWING FAILED CLEAN CATCH ATTEMPTS. • Please note clean catch is recognised best practice for urine collection in infants and children as outlined by NICE Clinical Guidelines 54 in 2007. Please refer to PROCEDURE FOR CLEAN CATCH URINE COLLECTION FROM INFANTS AND CHILDREN FOR MICROBIOLOGY SAMPLE prior to using these guidelines. • • • • If a clean catch sample is unobtainable: Other non-invasive methods such as urine collection pads should be used. 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 2.1 ACTION 1. Explain procedure to parents and child as relevant, and obtain informed consent. 2. Wash child’s genital area with lukewarm water. Dry front to back. To avoid other organisms contaminating the sample do not apply any creams, talc or antiseptics. Clinical Guideline for urine sample collection from infants and children using urine collection pad. Page 1 of 7 3. To avoid the nappy absorbing the urine: Stick the pad on the plastic side (inside out) of the disposable nappy, put nappy on the baby. Use both pads provided if child is older. 4. To ensure accuracy of the catch ensure pad is positioned over the urethral meatus/penis area. 5. Check every 10 minutes, to see if the child has wet the pad. If the child has soiled the pad you must start the procedure again. This is essential to minimise sample contamination. 6. As soon as the pad is wet remove it from the nappy. 7. Lay the pad down wet side up on an appropriate clean surface. 8. Take 5ml syringe, place tip on the pad and pull the plunger up, extracting the urine. Repeat aspiration several times, until required amount of urine is obtained. 9. Place urine into universal sterile container provided by PHLS. Do not use container provided in pad pack as it is prone to leaking in the hospital pod system. Clearly mark sample ‘PAD SAMPLE’. Send to relevant laboratory. 10. Discard waste appropriately. 11. Document in patient’s notes/care profile sample collected include method obtained and Date and Time in compliance with RCHT trust standards for documentation and sample collection. 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. Clinical Guideline for urine sample collection from infants and children using urine collection pad. Page 2 of 7 3. Monitoring compliance and effectiveness Element to be monitored Lead Correct use of urine collection pads. Tool Frequency Reporting arrangements Acting on recommendations and Lead(s) Change in practice and lessons to be shared Audit. Annually. Lead nurse and ward managers. Departmental audit and guidelines group. Lead nurse and ward managers. Departmental audit and guidelines group. W ard mangers and auditors. Possible wording to use for this column. Required changes to practice will be identified and actioned within6 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. Clinical Guideline for urine sample collection from infants and children using urine collection pad. Page 3 of 7 Appendix 1. Governance Information Document Title Clinical guideline for urine sample collection from infants and children using urine collection pad. Date Issued/Approved: 22 nd March 2013 Date Valid From: 22 nd March 2013 Date Valid To: 22 nd March 2016 Directorate / Department responsible (author/owner): Tabitha Fergus- Child Health Contact details: 01872252008 Brief summary of contents Clear guidance and directions on best practice for urine collection from infants and children and how to obtain a sample using a collection pad. Paediatrics Urine collection Sample Child Infant RCHT Suggested Keywords: Target Audience PCT CFT Executive Director responsible for Policy: Frances Keane Date revised: March 2013 This document replaces (exact title of previous version): Urine pad collection in infants. Approval route (names of committees)/consultation: Paediatric consultants Senior nursing staff Child health audit and guidelines group Practice development group 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): Document Library Folder/Sub Folder {Original Copy Signed} Internet & Intranet Paediatrics/neonatal Clinical Guideline for urine sample collection from infants and children using urine collection pad. Page 4 of 7 Intranet Only Links to key external standards NICE Clinical Guidelines 54. Urinary Tract Infection in Children. August 2007. Urine Pad Collection In Infants. Original guidelines. Zoe Baker and PDD. March 2004. Nursing Times. Urine Collection in infants and children. Feb 2008. Alder Hey Children’s NHS. Clean Catch Urine Collection. Related Documents: No –no change in practice since original document. Training Need Identified? Version Control Table Date Versio n No March 2004 V1.0 Summary of Changes Changes Made by (Name and Job Title) Initial Issue Zoe McClean Feb 11 V2.0 Update and re format. Tabitha FergusDeputy ward manager March 2013 V3.0 Update and re format. Tabitha FergusDeputy 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. Clinical Guideline for urine sample collection from infants and children using urine collection pad. Page 5 of 7 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 urine sample collection from infants and children using urine collection pad. Directorate and service area: child health Is this a new or existing Procedure? existing Name of individual completing Telephone:01872252008 assessment: T. Fergus 1. Policy Aim* Clear and best practice guidelines on urine collection from infants and children. 2. Policy Objectives* To provide clear and best practice guidelines on urine collection from infants and children. 3. Policy – intended Outcomes* Best practice throughout the department. 5. How will you measure the outcome? audit 5. Who is intended to benefit from the Policy? Service users and health care professionals 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 Paeds consultants, senior staff nurses, practice who have been consulted development, audit and guidelines group. about this procedure. *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. Clinical Guideline for urine sample collection from infants and children using urine collection pad. Page 6 of 7 Equality Group Age Positive Impact x Negative Impact No Impact Reasons for decision Child health policy 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_______________________ Clinical Guideline for urine sample collection from infants and children using urine collection pad. Page 7 of 7
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