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G375(P) Analysis of doctors and nurses confidence with the use of in and out urinary catheters for collection of urine samples
  1. H Fox,
  2. M Gupta
  1. Paediatrics, Shrewsbury and Telford NHS Trust, Telford, UK

Abstract

Background NICE recommends collecting urine by a clean catch sample to diagnose urinary tract infection (UTI), but if not possible or practical, to use urinary catheters (UC) to collect urine. Despite a policy to obtain clean catch urine, we have noticed high contamination rates, especially in infants. This creates diagnostic uncertainty, leading to unnecessary investigations and overuse of antibiotics. Using a UC to obtain urine can reduce rates of contamination, but experience among staff is low in our department as UC are not commonly used for this purpose. In this survey we explore the confidence, competence and training of staff with UC for collection of urine samples.

Methods A survey of medical and nursing staff was undertaken during a typical working week in October 2016. We asked about their experience, confidence and competence with insertion of UC to obtain urine samples in children. Results were analysed using Microsoft Excel.

Results 30 staff completed the questionnaire including 12 nurses, 3 advanced paediatric nurse practitioners (APNP), 9 tier 1 doctors (Foundation, GP and CT1–3 paediatrics trainees) and 6 tier 2 doctors (CT4 and above). 33% of Band 5 nurses, 67% of band 6 nurses, 75% of Tier 1 paediatric trainees and none of the foundation and GP trainees have inserted a UC in children. 50% of junior doctors and 53% nurses have never received training on UC insertion in children. 7% of all nurses and 67% of all doctors feel competent with insertion of UC in boys, whereas 40% of all nurses and 53% of all doctors surveyed feel competent with insertion of UC in girls.

Conclusion This survey identified that experience of UC insertion is low among nursing and junior medical staff, which is reflected in their perceived competence. This may be due to infrequent use of this procedure. Most staff identified the need for more training. Therefore we recommend using a standard operating procedure to allow structured training of junior medical and nursing staff. Considering UC more often in clinical practice will improve confidence and maintain competency of staff, and reduce the incidence of contaminated urine samples, especially in infants.

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