The Royal Marsden Hospital Manual of Clinical Nursing Procedures - Lisa Dougherty [426]
Postprocedure
8 Remove cap from plastic transport tube. To avoid contamination of the swab (HPA 2008a, C).
9 Carefully place swab into plastic transport tube, ensuring it is fully immersed in the transport medium. Ensure cap is firmly secured. To avoid contamination of the swab and to maintain the viability of the sampled material during transportation (Ferguson 2005, E).
10 Remove gloves and apron and wash/decontaminate hands. To reduce risk of cross-infection (DH 2006, C).
11 Complete microbiology request form (including relevant information such as exact site, nature of specimen and investigation required). To maintain accurate records and provide accurate information for laboratory analysis (NMC 2009, C; Weston 2008, E).
12 Arrange prompt delivery to the microbiology laboratory. To increase the chance of accurate organism identification and to ensure the best possible conditions for laboratory analysis (Higgins 2007, C).
Procedure guideline 11.6 Swab sampling: nose
Essential equipment
Gloves
Apron
Sterile bacterial or viral swab (with transport medium)
Appropriate documentation/form
Optional equipment
0.9% sodium chloride
Preprocedure
Action Rationale
1 Explain and discuss the procedure with the patient. To ensure the patient understands the procedure and gives valid consent (NMC 2008b, C).
2 Wash hands with bactericidal soap and water, or decontaminate physically clean hands with alcohol-based handrub. Don apron and gloves. To reduce the risk of cross-infection and specimen contamination (DH 2007a, C).
Procedure
3 Ask patient to tilt head backwards. To optimize visualization of area to be swabbed (Gould and Brooker 2008, E).
4 Moisten swab with sterile saline To prevent discomfort to the patient as the nasal mucosa is normally dry and organisms will adhere more easily to a moist swab (Hampson 2006, C).
5 Insert swab inside the anterior nares with the tip directed upwards and gently rotate (see Action Figure 5). To ensure that an adequate specimen from the correct site is obtained and to avoid damage to the delicate epithelium (Gould and Brooker 2008, E).
6 Repeat the procedure with the same swab in the other nostril. To optimize organism collection. E
Postprocedure
7 Remove cap from plastic transport tube. To avoid contamination of the swab (HPA 2008a, C).
8 Carefully place swab into plastic transport tube, ensuring it is fully immersed in the transport medium. Ensure cap is firmly secured. To avoid contamination of the swab and to maintain the viability of the sampled material during transportation (Ferguson 2005, E).
9 Provide the patient with a tissue if required. For patient comfort (Higgins 2008, E).
10 Remove gloves and apron and wash/decontaminate hands. To reduce risk of cross-infection (DH 2006, C).
11 Complete microbiology request form (including relevant information such as exact site, nature of specimen and investigation required). To maintain accurate records and provide accurate information for laboratory analysis (NMC 2009, C; Weston 2008, E).
12 If sample taken for screening: state clearly on the microbiology request form, for example for MRSA screening. To ensure only these organisms are being analysed, so the result will only indicate their presence or absence, and sensitivities (HPA 2008d, C).
13 Arrange prompt delivery to the microbiology laboratory. To increase the chance of accurate organism identification and to ensure the best possible conditions for laboratory analysis (Higgins 2007, C).
Action Figure 5 Area to be swabbed when sampling the nose.
Procedure guideline 11.8 Swab sampling: rectum
Essential equipment
Gloves
Apron
Sterile bacterial or viral swab (with transport medium)
Appropriate documentation/form
Preprocedure
Action Rationale
1 Explain and discuss the procedure with the patient. To ensure the patient understands the procedure and gives valid consent (NMC 2008b, C).
2 Ensure a suitable location in which to carry out the procedure. To maintain patient