The Royal Marsden Hospital Manual of Clinical Nursing Procedures - Lisa Dougherty [428]
Postprocedure
4If for swab specimen: remove cap from plastic transport tube. To avoid contamination of the swab (HPA 2008a, C).
5 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).
6 Remove gloves and apron and wash/decontaminate hands. To reduce risk of cross-infection (DH 2006, C).
7 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).
8 Arrange prompt delivery to the microbiology laboratory (keep at room temperature). To increase the chance of accurate organism identification and to ensure the best possible conditions for laboratory analysis (Higgins 2007, C).
Procedure guideline 11.10 Swab sampling: throat
Essential equipment
Gloves
Apron
Sterile bacterial or viral swab (with transport medium)
Appropriate documentation/form
Tongue spatula
Light source
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 sit upright facing a strong light, tilt head backwards, open mouth and stick out tongue. To ensure maximum visibility of the area to be swabbed and avoid contact with the oral mucosa (Gould and Brooker 2008, E).
4 Depress tongue with a spatula. The procedure may cause the patient to gag. The spatula prevents the tongue moving to the roof of the mouth, which would contaminate the specimen (Rushing 2006, E).
5 Ask patient to say ‘Ah’. To relax the throat muscles and help minimize the gag reflex (Rushing 2006, E).
6 Quickly but gently roll the swab over any area of exudate or inflammation or over the tonsils and posterior pharynx (see Action Figure 6). To obtain the required sample (Weston 2008, E).
7 Carefully withdraw the swab, avoiding touching any other area of the mouth or tongue. To prevent contamination of the specimen with the resident flora of the oropharynx (Weston 2008, E).
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 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).
Action Figure 6 Area to be swabbed when sampling the throat.
Procedure guideline 11.11 Swab sampling: low vagina
Essential equipment
Gloves
Apron
Sterile bacterial or viral swab (with transport medium)
Appropriate documentation/form
Light source
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 privacy