title: Improving clean-catch contamination rates: A prospective interventional cohort study.
abstract: OBJECTIVE
  The clean-catch method of urine collection carries a high contamination rate. This study aims to evaluate the effects on contamination rate of providing a parent handout and pre-made urine collection pack for clean-catch urine collection.
  
  
  METHODS
  We conducted a single-centre prospective cohort interventional study in a tertiary paediatric ED. All children younger than 24 months who presented from April 2013 to June 2014 requiring a urine sample to be obtained were included. The intervention was provision of a pre-made urine collection pack including a standardised information handout. The primary outcome measure was the difference in proportion of urine contamination in samples obtained via a clean-catch pre- and post-intervention.
  
  
  RESULTS
  The total number of urine specimens included was 288 in the pre-intervention group and 333 in the post-intervention group. Contamination rates were 14.9% in the pre-intervention group and 11.4% in the post-intervention group. There was no statistically significant reduction in contamination (P = 0.19). The contamination rates appeared to be associated with gender, with (pooled) female contamination rates being 16.4% (44/269) and male contamination rates being 10.5% (37/352). Most specimens of urine were collected via the clean-catch method (81.2%), followed by catheter urine specimen (13.7%) and suprapubic aspirate (5.1%). The contamination rate in our study for clean-catch urine collectively was 13%, catheter urine specimen 3.8% and suprapubic aspirate 0%.
  
  
  CONCLUSIONS
  The contamination rate of clean-catch urine did not improve with the implementation of a pre-made urine collection pack including standardised written instructions.
authors: Paediatric Emergency Department, Monash Children's Hospital, Melbourne, Victoria, Australia.
authors: Sharon
authors: S
authors: Teo
authors: Paediatric Emergency Department, Monash Children's Hospital, Melbourne, Victoria, Australia.|Monash Emergency Research Collaborative, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.|Paediatric Emergency Department, The Royal Children's Hospital, Melbourne, Victoria, Australia.|Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
authors: John A
authors: JA
authors: Cheek
authors: Paediatric Emergency Department, Monash Children's Hospital, Melbourne, Victoria, Australia.|Monash Emergency Research Collaborative, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.|Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
authors: Simon
authors: S
authors: Craig
mesh_terms: D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D008297:Male; D010353:Patient Education as Topic / Q000379:methods*; D011446:Prospective Studies; D012737:Sex Factors; D014556:Urine / Q000382:microbiology*; D059349:Urine Specimen Collection / Q000379:methods*
keywords: clean-catch urine; febrile child; urinary tract infection