Infection Control and Specimen Collection Flashcards

Laboratory Testing

• Used to identify specific bacteria or virus.

Nursing and Lab Tests

• Help diagnose, assess disease progression, and monitor treatment response.

• Nurses responsible for specimen collection, tracking outcomes, and sharing results.

• Some tests done by nurses, others by trained technicians.

• Some tests also measure which therapies will be effective in treating the condition.

Nursing Responsibilities

• Correctly collect specimens

• Monitor patient outcomes

• Ensure timely tests

• Share results with interdisciplinary team

Principles of Practice

• Utilize proficiency and judgment

• Minimize discomfort

• Promote safety

• Ensure accuracy/quality

• Protect self from exposure

• Follow employer policies

Person-Centered

• Handle specimens discreetly

• Consider cultural differences and language barriers

• Protect privacy

• Ensure DIPPS

Evidence-Informed Practice

• Advocate for needed specimens based on assessment data.

• Follow up-to-date policies.

Patient Identifiers

• Identify patient using 2 positive identifiers.

• Label specimen with date, time, and initials.

• Include additional information (Left vs Right; numbered locations).

• Lab may deny processing if not done correctly.

Types of Specimen

• Urine

• Stool

• Sputum

• Tissue (Nares/groin)

• Blood

Urine Specimens

• Urinalysis

• Urine Dipstick

• Urine Culture and Sensitivity

• 24-hour Urine Collection

How to Collect a Sample for Urinalysis

• Random Urine:- Use a specimen hat in continent patients who can use a toilet.

  • Approximately 120ml of urine is required. (Sometimes minimum 30ml depending on the lab). pour into the specimen container, label it, and send it to the lab.

• Dipstick:- Done on-site without sending to lab.

  • Collect sample and dip stick according to instructions.

  • Compare results to guide on bottle.

• Incontinent Clients:- Insert an “in and out” catheter to collect the specimen and then remove.

  • Label specimen and send to lab.

• Clients with Indwelling Catheters:- Clamp foley catheter BELOW the sampling port.

  • Wait 15-30 minutes, then access sampling port with luer-lock syringe.

  • Aspirate 20mL of urine into syringe and transfer to sterile container.

  • Label container and send to lab.

Urine for Culture and Sensitivity

• Confirms suspected urinary tract infection and identifies bacterial source (culture).

• The urinary tract is typically sterile (no bacteria).

• Sensitivity test determines which antibiotics the bacteria is susceptible to.

How to collect a sample for Culture and Sensitivity

• Maintain sterility.

• Collect urine “mid-stream” directly into sterile specimen container.

Continent Clients “Midstream” Collection

• Clean peri-area prior to voiding.

• Initiate stream into toilet before catching urine in cup

• Collect 90-120mL of urine in the specimen cup. (Nursing Times, 2017)

Storage of Urine C+S

• Urine should be kept in the fridge or on ice until it can be sent to the lab for testing.

24-Hour Urine Collection

• Measures amounts of substances (amino acids, creatinine, glucose, hormones, adrenocorticosteroids) in urine over 24 hours.

• Helps diagnose or monitor kidney disease, hormonal imbalances, metabolic disorders.

How to Collect

• Collect all voided urine over 24-hour period (patient and staff must collaborate).

• Begin in the morning AFTER the first void.

• Pour urine into specialized container (provided by lab).

• If client voids in the toilet during the 24-hour period, the test will need to be restarted

Storage

• The specimen container should be placed in the patient’s bathroom or the soiled utility room.

• Place specimen container on ice to preserve sample.

• Post a sign to remind patient and staff that a test is in progress.

• Label container with patient identification information.

• Number multiple containers sequentially.

Stool Specimens

• Hemoccult

• Infections Panel (Including C.Diff)

• Ova + Parasite

Hemoccult

• Also known as Fecal Occult Blood (FOB) or FIT testing.

• Screens for occult (not visible) blood in stool.

• Useful for screening for occult (not visible) blood in the stool.

• If positive, further testing is recommended (colonoscopy).

• False positive: ingestion of red meat within 3 days of testing.

• False negative: taking Vitamin C.

How to Collect

• Use a specimen hat, commode, or bedpan.

• Smear stool on cardboard specimen card using wooden or plastic applicator.

• Label and send to lab.

• Often requires 3 separate stool smears.

Infectious Disease Panel

• Stool Cultures help us screen for common enteric (occuring in intestines) pathogens (bacterial, viral AND fungal).

• Common microorganisms we are looking for include: Clostridium Difficile (C. Diff).

• Usually ordered for clients who has persistent diarrhea, especially if there is mucous or blood present.

How to Collect a Stool Culture

• Use a sterile specimen container.

• Using a sterile tongue depressor, place a sample taken from three different areas of the stool collection.

• A minimum of about 1 inch in diameter sample should be placed in the container.

• Use a container with a preservative if the sample cannot be taken to the lab immediately.

• Refrigerate specimens per agency protocol.

Ova and Parasites

• Typically ordered for clients who have recently travelled, are experiencing GI symptoms and often weight loss.

• Looking specifically for parasites and their eggs that commonly infect humans.

• Parasites we are looking for include: Human Whipworm, Liver Fluke, Ascaris, Pinworm, Pork and Bovine Tapeworm.

How to collect an O+P specimen

• It is the same protocol as collecting a stool sample, however, there are specific specimen containers to be used for this test.

Tissue Specimens

• ARO Swabs

• Throat Specimen Collection

ARO Swabs

• Many Health Authorities require an Antibiotic-Resistant Organism (ARO) Screening Questionnaire to be completed for all inpatients admitted to acute care.

• Identifies individuals at risk for carrying an ARO, specifically MRSA or CPO.

• If at risk, nasal and groin swabs should be collected for testing.

Throat Culture

• Collected from the mucosa of the oropharynx and tonsillar regions using a culture swab.

• Used for culturing organisms and identifying effective antibiotics.

• Very often used to identify strep throat.

• There are 'rapid' tests for strep throat that rely on throat cultures that can be developed immediately (these do not identify exact strain or do sensitivity testing).

How to Collect

• Specimen The swab should run along the tonsils and areas on the pharynx that are reddened or contain exudate.

• The swab is then placed in its container,