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Faster clean catch urine collection (Quick-Wee method) from infants: randomised controlled trial
Jonathan Kaufman1,2,3, Patrick Fitzpatrick1,2, Shidan Tosif1,2,3
1Royal Children's Hospital, Parkville, Victoria, Australia.
Insights
The Quick-Wee method, a simple stimulation technique, significantly increases infant voiding rates for clean catch urine collection within five minutes. This method improves successful sample collection and satisfaction for parents and clinicians.
Area of Science:
- Pediatrics
- Urology
- Clinical Trials
Background:
- Collecting clean catch urine samples from infants can be challenging and time-consuming.
- Standard methods often have low success rates and may require prolonged waiting periods.
Purpose of the Study:
- To evaluate the efficacy of the Quick-Wee method, a simple suprapubic cutaneous stimulation technique, in increasing infant voiding for clean catch urine collection.
- To compare the Quick-Wee method against standard clean catch urine collection without additional stimulation.
Main Methods:
- A randomized controlled trial was conducted with 354 infants aged 1-12 months requiring urine samples.
- Infants were randomized to either the Quick-Wee method (n=174) or standard clean catch urine collection (n=170).
- The primary outcome was urine voiding within five minutes, with secondary outcomes including successful collection, contamination rates, and satisfaction.
Main Results:
- The Quick-Wee method significantly increased voiding within five minutes (31% vs. 12%, P<0.001).
- Successful urine sample collection rates were higher with Quick-Wee (30% vs. 9%, P<0.001), alongside greater parental and clinician satisfaction.
- Contamination rates did not differ significantly between the groups (27% vs. 45%, P=0.29).
Conclusions:
- The Quick-Wee method is a simple and effective technique for enhancing infant voiding and improving the success rate of clean catch urine collection within five minutes.
- This method offers a practical solution for pediatric emergency departments seeking to expedite urine sample acquisition.
- The study demonstrates a significant improvement in clinical efficiency and patient/clinician experience.
Abstract:
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.