Interventional procedures for neonates

Required Equipment:

• A urine collection bag for newborns
• Antimicrobial soap
• Small pieces of sterile cotton
• Sterile water
• Test tubes for urine collection
• Sterile gloves

Steps for Collecting a Urine Sample:

·  Perform surgical handwashing.

·  Prepare the necessary equipment.

·  Confirm the newborn’s identity before proceeding.

·  Wear sterile gloves.

·  Clean the newborn’s genital area as follows:

For Female Newborns:

• Separate the labia and clean the area using a cotton ball soaked in antiseptic soap, wiping in one direction from the clitoris to the anus along one side of the urethral opening. Then, wipe with another cotton ball soaked in sterile water and dry the area.
• Use a second cotton ball to clean the other side of the urethral opening, then wipe with another sterile water-soaked cotton ball and dry.
• Clean the pubic area with a third cotton ball, followed by a sterile water-soaked cotton ball, and dry.

For Male Newborns:

• Clean the penis using a circular motion toward the scrotum. If the newborn is uncircumcised, gently retract the foreskin before cleaning, then dry the area.
• Clean the pubic area with a cotton ball, followed by a sterile water-soaked cotton ball, and dry.

·  Peel off the protective film from the lower half of the adhesive strip on the urine collection bag.

·  Place the urine collection bag over the vagina or penis and scrotum.

·  Press the adhesive strip onto the skin, starting from the narrow skin bridge between the anus and the genitalia, and move outward, ensuring firm adhesion.

·  Once the lower part of the adhesive strip is secured, remove the upper protective film and press the strip firmly onto the skin (avoiding wrinkles). The bag should now be correctly positioned.

·  Leave the bag in place until the newborn urinates.

·  The newborn is diapered.

·  Once urination occurs, carefully remove the bag.

·  Transfer the required urine amount from the collection bag to a sterile sample bottle.

·  Label the bottle with the newborn’s name, the unit from which the sample is taken, and the requested analysis type.

·  Send the sample to the laboratory immediately.

Urine Sample Collection via Bladder Aspiration:

Indications:

• Used for urine culture.

Contraindications:

• If the newborn has urinated within the last hour.
• Presence of skin infections above the bladder.
• Congenital abnormalities of the urinary or genital system.
• Blood clotting disorders.

Required Equipment:

• Sterile gloves
• Sterile gauze
• Forceps
• 5 mL syringe (three syringes)
• 21 and 25 gauge needles
• Antiseptic solution
• Sterile tubes with lids for sample collection

Procedure Steps:

• Confirm the newborn’s identity.
• Perform surgical handwashing and wear sterile gloves.
• Ensure there is urine in the bladder.
• Position the newborn on their back with the legs in a frog-leg position.
• Clean the sample collection site thoroughly.
• Prepare the urine collection container and transfer the urine into the sample bottle, sealing it tightly.
• Label the sample bottle with an appropriate adhesive strip, recording the urine volume.
• Send the sample to the laboratory.
• Safely dispose of used equipment in designated areas.
• Perform routine handwashing.
• Ensure the sample reaches the laboratory within 1–2 hours of collection.

2. Stool Sample Collection:

Required Equipment:

• Clean diaper
• Plastic or cellophane sheet
• Wooden tongue depressor
• Antimicrobial soap
• Large pieces of dry and moistened cotton
• Sample collection container
• Gloves

Procedure Steps:

• Perform routine handwashing.
• Prepare the necessary equipment.
• Confirm the newborn’s identity.
• Wear gloves.
• Remove the newborn’s diaper.
• Clean the anal and perineal area using a cotton ball soaked in antiseptic soap, wiping in one direction. Then, wipe with a cotton ball soaked in sterile water and dry.
• Place a clean diaper on the newborn.
• If the stool is solid, use a wooden tongue depressor to scrape a small amount from the diaper and place it into the sample collection container.
• If the stool is loose (diarrhea), place a piece of cellophane or plastic between the newborn’s body and the diaper to collect the stool before it is absorbed. Transfer the stool directly from the plastic sheet to the collection container.
• Label the container with the newborn’s name, the time of collection, the unit from which the sample is taken, and the requested analysis type.
• Send the sample to the laboratory immediately.
• Dispose of used equipment safely in designated areas.
• Perform routine handwashing.

Responsible Personnel:

• Nursing staff.