Creative alternatives to straight cath for infant urine cultures

[anon456, BSN, RN]

I work in a unit with a lot of babies birth to 3 mos. Most of the time I'm okay at getting the urine for a culture, but sometimes we have very difficult to cath baby girls. With regular UAs we often just put cotton balls in the diaper and then use a large syringe to squeeze it into a container. Obviously won't work for a sterile sample. Any suggestions or ideas?

[JustBeachyNurse, LPN]

when I worked ER we used to place sterile gauze or cotton in the sterile PUC (pediatric urine collection) bag, using as sterile technique as possible. Clean the baby with castile soap wipes then apply the PUC (again being as clean/sterile as possible so it was a 2 staff job...one to keep the legs stable, the other to be clean to apply the PUC.

Just like this: http://www.wkhs.com/Documents/Laboratory/Patient/Patient-Educatin-Pediatric-Urine-Collection.pdf

Using a product like this: Cardinal Health:Allegiance® Pediatric Urine Collector With Adhesive

[KelRN215, BSN, RN]

Urine bags are your next best thing but I've not had good luck with those over the years... they can fall off and then you end up trying multiple times before you're finally able to collect something like 3 cc.

[anon456, BSN, RN]

Thank you! I will try that next time. I think part of the problem too is that those straight caths in the kits are so flimsy. I cathed a bigger female a couple nights ago and ended up using a red robinson cath and had another nurse with sterile gloves hold the end to drain into a sterile cup. I'm about to fire those straight cath kits witht the flimsy clear tubing.

[anon456, BSN, RN]

I just wanted to give feedback that last night I had order to collect a sterile specimen from a young uncircumcised male. I used sterile gloves to place the sterile gauze in the bag and the cleaned the area and applied the bag. I used sterile gloves to retrieve the gauze and handle it and then sent the urine down to lab. It worked great! :-) Lab values were normal for a UA and still waiting on cultures.

[hiddencatRN, BSN, RN]

Thank you! I will try that next time. I think part of the problem too is that those straight caths in the kits are so flimsy. I cathed a bigger female a couple nights ago and ended up using a red robinson cath and had another nurse with sterile gloves hold the end to drain into a sterile cup. I'm about to fire those straight cath kits witht the flimsy clear tubing.

I actually like those kits. I find them pretty easy to use on the babies. Maybe it's just a matter of getting more comfortable with them?

We never bag if we need a culture, because it's just too easy for the bag to get contaminated.

[imaginations]

Thank you! I will try that next time. I think part of the problem too is that those straight caths in the kits are so flimsy. I cathed a bigger female a couple nights ago and ended up using a red robinson cath and had another nurse with sterile gloves hold the end to drain into a sterile cup. I'm about to fire those straight cath kits witht the flimsy clear tubing.

We often use a small french size feeding tube rather than an in/out catheter for a sterile urine sample on small/young children and babies as they seem to be easier to handle and do a better job

[nitasarn]

I hate cotton balls and bags for infants, especially for sterile because it wouldnt be sterile. I usually use the small 5fr 6 fr suction caths for suction trachs, its in a sterile container come with gloves. The catheter is really flexible