Nursing How To’s: Specimen Collection (Throat Swab Culture, Sputum Specimen and Culture)
Throat Swab Culture
A throat swab culture is a laboratory diagnostic test that evaluates for the presence of a bacterial or fungal infection in the throat. It is done to isolate and identify any pathogens, which may be medium. A sample of mucus and secretions from the back of the throat is collected on a cotton-tipped applicator and applied to a slide or a special cup that allows infections to grow. These infections can include strep throat, pneumonia, tonsillitis, whooping cough, and meningitis.
Supplies and Equipment
The supplies and equipment required to obtain a sample for throat culture are:
- Sterile cotton-tipped applicator specimen collection tip (culturette)
- Tongue depressor
- Laboratory request form
- Flashlight
Procedure
- Always observe proper hand hygiene prior to the test.
- Have the patient sit comfortably either on bed or chair while explaining the procedure.
- Allow the patient to tilt his head back and ask him to say “Ahhh.” Antiseptic mouthwash should be avoided before this test.
- Make use of the flashlight to light up the back of the throat and check for presence of inflammation using the tongue depressor.
- Swab the tonsillar areas from side to side and make sure to include any inflamed or purulent sites. The test may cause momentary gagging because the back of the throat is a sensitive area, but it should not be painful.
- Refrain from touching the tongue, cheeks, or teeth with the applicator, due to possible contamination with oral bacteria.
- Place the cotton-tipped applicator into the culture tube immediately.
- Label the culture tube with the patient’s name, SSN, and ward number if applicable.
- Fill out the request form completely with the following information:
- Patient’s name
- Patient’s rank or status
- Family member prefix and sponsor’s social security number
- Ward number if inpatient, or mobile number if outpatient
- Source of the specimen (e.g., throat)
- Any antibiotics the patient is taking
- Date and time the specimen was obtained
- Name of the physician who ordered the culture
- The sample is then taken to the laboratory for culture.
Sputum Specimen and Culture
A sputum specimen is a sample of material expelled from the respiratory passages taken for laboratory analysis to determine the presence of pathogens. A specimen of mucus from the lungs expectorated through the mouth or obtained via tracheal suctioning with an in-line trap or bronchoscope. Specimens are often taken for three consecutive days because it is difficult for the patient to cough up enough sputum at one time, and an organism may be missed if only one culture is done.
Supplies and Equipment
Supplies and equipment required to collect a sputum specimen are:
- Sterile container with tight-fitting lid
- Emesis basin
- Box of tissues
- Gloves
- Goggles
- Aerosol of 10% sodium chloride or sterile water (optional)
- Nebulizer (optional)
- Laboratory request form
Procedure
- Observe proper hand hygiene and gather equipment.
- Provide privacy for the patient and explain the entire procedure.
- Position your patient in a chair or on the side of bed. If he is not capable of sitting alone, place him in a high-Fowler’s position. Remove dentures, if he has them.
- Place the tissues nearby and have the patient rinse his mouth with clean water to remove any food particles. Don’t allow him to brush his teeth or use mouth wash. Doing so could kill bacteria in the sputum, rendering it useless.
- Don gloves and goggles. Uncap the container but avoid touching the inside to ensure that it’s sterile.
- Using the sterile collection container provided, instruct the patient to take three deep breaths, then force a deep cough and expectorate into a sterile screw-top container. To prevent contamination by particles in the air, keep the container closed until the patient is ready to spit into it.
- If you don’t get an adequate sample on the first try, have him continue to cough until you’re able to collect a minimum of 15 ml. If the patient has trouble bringing up secretions, however, have him breathe into the nebulizer and try again.
- Once you’ve collected the specimen, securely cap the container. Remove and discard your gloves and wash your hands thoroughly. Allow the patient to rinse out his mouth and provide a tissue.
- Record the amount, consistency, and color of the sputum collected, as well as the time and date in the nursing notes.
- Send the sample to the lab immediately, without refrigeration.
Sources:
https://sites.google.com/site/nursingstudentsnote/family-blog/diagnostictestandspecimencollection
Liane Clores, RN MAN
Currently an Intensive Care Unit nurse, pursuing a degree in Master of Arts in Nursing Major in Nursing Service Administration. Has been a contributor of Student Nurses Quarterly, Vox Populi, The Hillside Echo and the Voice of Nightingale publications. Other experience include: Medical-Surgical, Pediatric, Obstetric, Emergency and Recovery Room Nursing.
