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Collection of specimens/swabs
Val Dimmock, Lecturer in Practice

Procedure
The purpose of this presentation is to demonstrate the correct procedure
for taking a variety of swabs. Please note that policies and procedures
may vary in different Trusts. It is essential that you have had training
on the specific techniques before performing this skill.

It is the personal and professional responsibility of healthcare

practitioners to ensure that they are competent to undertake this
procedure.

Specimens of tissue or fluid are collected when microbiological;

biochemical or other laboratory investigations are required to aid
diagnosis. The results of such investigations may classify the disease
and determine diagnosis and treatment.

General principles:

Successful collection of specimens will depend on the following:

Collection at the appropriate time

Use of the correct technique

Use of the correct equipment

Safe transportation to the laboratory without delay

Healthcare practitioner’s role:

To identify the requirement of a microbiological investigation

To initiate the procedure

To collect the desired material in the correct container

To arrange prompt delivery to the laboratory

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Collection of specimens/swabs
Collection of specimens:

• Samples should be collected before the start of any treatment

• If an unusual specimen is required check any specific requirements
with the laboratory eg skin and mucous membranes, pus, biopsies

Types of investigation:

• Bacterial – culture and sensitivity

• Viral – culture; serology; ideally taken in hospital as viruses do not
survive long outside the body
• Serological – antigens and antibodies
• Mycosis – fungal
• Protozoa – malaria

Check your knowledge on infection control and organisms that cause the
infections:
http://www.cetl.org.uk/learning/infection-control-output/quizmaker.html

Generic equipment required

Sterile Water Disposable
gloves
as
necessary

Spatula Labelled Specimen

Container
Swab in Transport
Medium Laboratory Request
Form

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Collection of specimens/swabs
Documentation
The following information must be given when sending a specimen:
• Persons’ name
• Address
• Date of birth
• Date of specimen collection
• Time specimen collected
• Diagnosis
• Relevant history eg recent travel abroad
• Type of specimen
• Any antibiotic therapy already being
administered
• Name of requesting doctor

General procedure

Action Rationale

Explain and discuss procedure with the To ensure the person understands
person the procedure and gives consent
Collect equipment and check all expiry To prevent contamination
dates
Wash hands To prevent contamination
Wear gloves To prevent cross infection
Take the swab using the correct
technique
Place the specimen/swab in the correct To ensure the organisms for
labelled container investigation are preserved
Send the specimen/swab to the To ensure optimum conditions for
laboratory with completed documentation laboratory examination
Dispose of equipment as per trust policy

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Collection of specimens/swabs

Nose swab

Action Rationale
Moisten swab beforehand with sterile To prevent discomfort to the patient
water
Move swab from the anterior nares and To swab the correct site and obtain
direct upwards into the tip of the nose required sample
Gently rotate the swab once

Sputum specimen

Action Rationale
Use a clean, not necessarily sterile Sputum is never free from organisms
container due to passing through the pharynx and
mouth
Ensure that the specimen is sputum To obtain the required sample
NOT saliva
Encourage the person to cough deeply To facilitate expectoration
or request the help of a physiotherapist

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Collection of specimens/swabs

Tonsilar fossa

Throat swab

Action Rationale
Sit the person facing a strong light and To ensure you can see the area to be
depress the their tongue with a spatula swabbed. The procedure is likely to
make the individual gag – the tongue
moving to the roof of the mouth will
contaminate the specimen
Quickly but gently swab the tonsillar To obtain the required sample
fossa or any area with a lesion or
visible exudate
Avoid touching any other area of the To prevent contamination
mouth or tongue

Ear swab

Action Rationale
No drops should have been used 3 To prevent collection of therapeutic
hours prior to taking the swab material
Place the swab into the outer ear and To avoid trauma to the ear and collect
rotate gently once secretions

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Collection of specimens/swabs

Wound swab

Action Rationale
Take the swab before cleaning the To collect the maximum number of
wound organisms
Rotate the swab gently once To collect the sample

Urine specimen – early morning

Action Rationale
The bladder will be full due to
Early morning specimen required overnight accumulation of urine – later
specimens may be diluted
Place the specimen in the correctly To ensure the organisms for
labelled container investigation are preserved

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Collection of specimens/swabs

Urine specimen – mid-stream

Action Rationale
Ask the person or assist the them to To prevent other organisms
wash around the urethral area contaminating the specimen
Ask the person to discard the first and To avoid contamination with skin
last part of micturation and collect the organisms
middle stream

Urine specimen – catheter

Action Rationale
Clean the access point on the tubing To reduce cross infection

If there is no urine, To obtain an adequate specimen

clamp the tubing below the access
point
Using a sterile needle and syringe To prevent leakage
aspirate urine through the access point
Re-clean the access point To reduce contamination

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Collection of specimens/swabs

Faeces specimen

Action Rationale
Person to defaecate into a clean To avoid unnecessary contamination
bedpan
Scoop enough material to fill a third of To obtain a usable amount of
the specimen pot specimen
Record colour, consistency and odour To maintain an accurate baseline
record
Segments of tapeworm are easily seen Laboratory confirmation of the head of
– send to the laboratory the tape worm is required to prevent
further growth

References

Baillie L. (2005), Developing Practical Nursing Skills 2nd ed. Edward Arnold

Dougherty L., Lister S. (2004), The Royal Marsden Hospital Manual of Clinical
Nursing Procedures 6th ed. Blackwell Publishing

Jamieson E.M., Whyte L.A., McCall J.M. (2007), Clinical Nursing Practices 5th ed.
Churchill Livingstone Elsevier

Johnson, R., Taylor, W. (2006), Skills for Midwifery Practice 2nd Ed Edinburgh
Elsevier Churchill Livingstone

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