Faster clean catch urine collection (Quick-Wee method) from infants: randomised controlled trial.
Kaufman, Jonathan paediatric trainee; Fitzpatrick, Patrick paediatrician; Tosif, Shidan paediatrician; Hopper, Sandy M paediatric emergency physician; Donath, Susan M associate professor; Bryant, Penelope A associate professor; Babl, Franz E associate professor
[Article]
BMJ.
357:j1341, April 8, 2017.
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Objective: To determine if a simple stimulation method increases the rate of infant voiding for clean catch urine within five minutes.
Design: Randomised controlled trial.
Setting: Emergency department of a tertiary paediatric hospital, Australia.
Participants: 354 infants (aged 1-12 months) requiring urine sample collection as determined by the treating clinician. 10 infants were subsequently excluded.
Interventions: Infants were randomised to either gentle suprapubic cutaneous stimulation (n=174) using gauze soaked in cold fluid (the Quick-Wee method) or standard clean catch urine with no additional stimulation (n=170), for five minutes.
Main outcome measures: The primary outcome was voiding of urine within five minutes. Secondary outcomes were successful collection of a urine sample, contamination rate, and parental and clinician satisfaction with the method.
Results: The Quick-Wee method resulted in a significantly higher rate of voiding within five minutes compared with standard clean catch urine (31% v 12%, P<0.001), difference in proportions 19% favouring Quick-Wee (95% confidence interval for difference 11% to 28%). Quick-Wee had a higher rate of successful urine sample collection (30% v 9%, P<0.001) and greater parental and clinician satisfaction (median 2 v 3 on a 5 point Likert scale, P<0.001). The difference in contamination between Quick-Wee and standard clean catch urine was not significant (27% v 45%, P=0.29). The number needed to treat was 4.7 (95% confidence interval 3.4 to 7.7) to successfully collect one additional urine sample within five minutes using Quick-Wee compared with standard clean catch urine.
Conclusions: Quick-Wee is a simple cutaneous stimulation method that significantly increases the five minute voiding and success rate of clean catch urine collection.
Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12615000754549.
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