CLINICAL SPECIMENS.pptx

Clinical

1. CLINICAL SPECIMENS BY GROUP 4

2. CLINICAL SPECIMENS The various types of specimens, such as bloods, urine, feces and CSF (cerebrospinal fluid) that are collected from patients and used to diagnose or follow the progress of infectious disease. SPECIMEN; is a sample or a small part of a substance or a thing taken for the purpose of determining the character of a whole.

3. 15.TYPES OF CLINICAL SPECIMENS USED IN THE CLINICAL SETTING TO DIAGNOSE INFECTIONS TYPES OF SPECIMEN TYPES OF INFECTIOUS DISEASE THAT THE SPECIMEN IS USED TO DIAGNOSE Blood B, F, P, V CSF B, F, P, V Feces and rectal swabs B, P, V Pus from a wound or abscess B Sputum B, F, P Urine B, P, V

4. IMPORTANCE OF HIGH QUALITY SPECIMENS High quality clinical specimen are required to achieve accurate, clinically relevant laboratory results.

5. 15.1.COMPONENTS OF SPECIMEN QUALITY Proper specimen selection( i.e. the correct type of specimen must be submitted) Proper specimen collection Proper transport of the specimen to the laboratory NB: The laboratory must provide written instructions for the proper selection, collection and transport of clinical specimens

6. 15.2 HOW THE HIGH QUALITY SPECIMEN COLLECTED IN CAN BE ACHIEVED? Specimen required; sputum The specimen should be collected in the morning before eating. It should be sputum, thick not salivary Sputum bottle should be sterile and well labelled, well closed with tight lid. Proper mouth hygiene. Sample should be placed away from heat and sunlight

7. 15.3 GENERAL PRINCIPLES FOR PROPER SELECTION, COLLECTION AND TRANSPORTATION OF CLINICAL SPECIMEN The specimen must be properly selected. It must be properly and carefully collected. The material should be collected from the site where the suspected pathogen is most likely to be found. It should be collected where the least contamination is likely to occur. It should be obtained before antimicrobial therapy and at the acute stage of the disease It should be performed with care and tact to avoid harming the patient.

8. A sufficient quality of the specimen must be obtained All specimen should be placed or collected into a sterile container to prevent contamination . Specimens should be protected from heat and cold. It must be handled with great care to avoid contamination of patients, couriers, and healthcare professionals The specimen container must be properly labeled and accompanied by an appropriate laboratory test requisition. Specimen should be collected and delivered to the laboratory as early in the day as possible.

9. 15.4 HOW A NURSE CAN MINIMISE CONTAMINATION OF CLINICAL SPECIMENS. Use properly sealed lids Use of sterile containers Containers must be disposable

10. CLINICAL PRESENTATION OF THE PATIENT TYPE OF SPECIMEN TO BE COLLECTED PROCEDURE OF COLLECTING THE SPECIMEN HOW TO TRANSPORT THE SPECIMENT TO THE LAB Genital ulcers, PV discharge Blood washing hands Wearing gloves Locating suitable vein Disinfect the site Draw blood with the sterile needle Use well labeled appropriate blood collection tube. Specimen should be placed in a cool box transported to the lab

11. Amenorrhea Urine The ideal specimen for a urine culture is a clean-catch, midstream urine specimen. Transport ASAP Cough, fever, Loss of weight, Loss of appetite Sputum Use well labeled sterile container with proper sealed lid. handled with care and transport ASAP Mental confusion, severe headache, stiff neck CSF (Cerebro-spinal fluid) Collect in to a sterile tube by a lumbar puncture, recap a specimen container Transport ASAP

12. Sore throat Throat swabs Direct light on to the back of the throat using small flashlight or other light source Depress the tongue with the tongue depressor and ask the patient to say ‘’ ahhh ’’ . Refer to page 250-251 Arrange the transport or deliver to the laboratory ASAP

13. Acute flaccid paralysis Fecal specimen The stool should be passed into a clean dry wide mouth container, onto a clean newspaper, or into a plastic bag or plastic wrap placed over the toilet. Collect areas of the stool which appear bloody, slimy or watery. Transport ASAP

14. Pus oozing from the wound Wound specimens Wash hands, put on gloves Wound specimen should be collected using small needles. Transport ASAP

15. 15.7WHAT INFLUENCED THE NURSE TO SELECT SPUTUM OVER OTHER CLINICAL SPECIMENS Because the patient had all the signs of TB; such as loss of appetite, excessive sweating at night, coughing for a period of two week and two days so sputum is the right specimen to check whether the patient had TB or not .

16. NOSOCOMIAL INFECTIONS(HEALTHCARE ASSOCIATED INFECTIONS) This are infections that are acquired within hospitals or other healthcare facilities.

17. 16.1 PATHOGENS INVOLVED Gram-positive cocci Staphylococcus aureus Coagulase- negative staphylococcus Enterococcus spp Gram-negative bacilli Escherichia coli Pseudomonas aeruginosa Klebsiella pneumonia Enterobacter spp

18. ROUTES THROUGH WHICH THESE PATHOGENS CAN BE TRANSMITTED Contact transmission Droplets transmission Airborne transmission

19. PEOPLE LIKELY TO DEVELOP NOSOCOMIAL INFECTIONS Elderly people Women in labor and delivery Premature infants and newborns Patients having an organ transplant Patients receiving treatment with steroids, anticancer drugs or radiation. Immunosuppressed patients

20. COMMON TYPES OF HAIs UTIs Surgical site infections Lower respiratory tract infections (pneumonia) Septicemia (blood stream infections)

21. 16.2 FACTORS THAT CONTRIBUTE TO NOSOCOMIAL INFECTIONS (MAJOR) An ever increasing number of drug-resistant pathogens The failure of healthcare personnel to follow infection control guidelines. A n increased immunocompromised patient For additional factors, refer to page 219

22. ROLES OF THE NURSE IN REDUCING HAIs Wash hands before, Prepariing and eating of food Treating a cut or wound Attending patients Washing hands after, Using restroom Handling of uncooked food Touching pets

23. Coughing, sneezing, and blowing the nose Handling garbage Attending patients Changing a diaper Wash hands properly with, Soap and water Under running water For 20 sec Dry hands TABLE 16.1

24. 16.3 PATHOGENS MODE OF TRANSMISSION Micobacterium airborne Treponema pallidum contact Common cold virus droplets

25. 16.4 FACTORS DESCRIPTION OF HOW IT CONTRIBUTES CONTROL/PREVENTION Increasing number of drug resistant pathogens Take medication as prescribed and finish the cause Failure of healthcare personnel to follow infection control Cross infection from one patient to another Wash hands with soup and water under runny water Wear appropriate PPE

26. Increased number of immunocompromised patients Pre dispose patients to infections Health education on chronic illness healthy lifestyle vaccination

27. Types of nosocomial infection Cause/contributing factors Prevention by a nurse UTI Over use and improper use of indwelling medical devices e.g. catheter Increase fluid intake Wipe from front to back Frequently urinate Surgical site infection Failure to follow infection control guidelines Proper wound care by clean and dressing of wound in sterile equipment.

28. Lower respiratory tract infections Over crowding of hospital and healthcare facilities Isolate sick patients Open windows for ventilation Avoid overcrowding of patients in one room.