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JOURNAL ARTICLE
RANDOMIZED CONTROLLED TRIAL

Faster clean catch urine collection (Quick-Wee method) from infants: randomised controlled trial

Jonathan Kaufman, Patrick Fitzpatrick, Shidan Tosif, Sandy M Hopper, Susan M Donath, Penelope A Bryant, Franz E Babl
BMJ: British Medical Journal 2017 April 7, 357: j1341
28389435
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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