COLLECTION OF SPECIMEN.pptx ..................

FUNDAMENTALS

1. OBSERVATION AND COLLECTION OF SPECIMENS BY T.SASHIKALA M.SC (N)

2. OBJECTIVES Definition of collection of specimen Purpose Key- terms Indications Types and their examinations General instructions Preliminary assessment Blood test Urine test Sputum test Collection of stool specimen

3. DEFINITION A specimen is a small sample or part taken to show the nature of the whole, as a small quantity of urine for analysis, or a small fragment of tissue for a microscopic study. - sushma pandey

4. PURPOSE To help in finding diagnosis. To evaluate the course of treatment provided. To differentiate the variation from normal to abnormal in sickness. To build clinical picture of the patient.

5. KEY-TERMS Specimen :- sample of body tissues taken for medical testing. Urinalysis :- it is a physical, chemical and microscopic examination of urine. Stool test :- this test involves series of tests in order to identify conditions affecting GI tract. Gastric analysis :- it is the aspiration of stomach content through a nasogastric tube for the laboratory study.

6. INDICATIONS For culture sensitivity to identify a specific organism and its drug sensitivity. For cytology to identify the origin, structure, function and pathology of cells. For assessment of the effectiveness of therapy. For routine health check-up.

7. TYPES AND THEIR EXAMINATIONS SPECIMEN TYPES OF EXAMINATION BLOOD ROUTINE EXAMINATION CULTURE URINE COLLECTION OF MID-STREAM URINE ROUTINE MICROSCOPIC CULTURE 24 HOURS URINE PREGNANCY TEST STOOL ROUTINE MICROSCOPIC CULTURE OCCULT BLOOD OVA AND CYST SPUTUM MICROSCOPIC ACID FAST BACILLI CULTURE NOSE, THROAT SWAB CULTURE WOUND SWAB CULTURE

8. COLLECTION OF SPECIMEN OF VOMITUS COLLECTION FOR VAGINAL SWAB SPECIMENS WOUND CULTURE THROAT CULTURE BLOOD CULTURE URINE ANALYSIS

9. GOOD PRACTICE PRINCIPLES Appropriate to the patient’s clinical presentation. Collected at the right time. Collected in a way that minimises cotamination . Collected in a way that reduce health and safety risk to all staff handling the specimen ( including laboratory staff). Collect using the correct equipment. Documented clearly using appropriate forms. Stored / transported appropriately.

10. GENERAL INSTRUCTIONS Collection to be done in a specific container Clean Sterile (for culture) Specific quantity for specific tests Labelled for clear identification All specimens must be collected fresh usually in the morning Follow the correct method of collection

11. All specimen should be well labelled with The patient’s name Bed no., Ward no., Registration no Date of collection, Doctor’s unit. Name of the specimen, investigations asked / required. For female patients, urine and stool specimens should be avoided during menstruation. If it has to be collected, put tampon in vagina before collection of specimen.

12. CONSENT Patients should give informed consent for specimen collection and, as part of the process, the nurse should - Inform the patient of the reason for specimen collection. Explain the procedure. Assess the patient’s understanding. Explain how long it will take for the results to be available and how the patient will receive them; Implications for care.

13. PRELIMINARY ASSESSMENT Preparation of the patient :- Explain the patient and relatives the need for collection of specimens. Explain the steps of procedure if the patient has to collect the specimen for himdelf or herself. Provide privacy if the patient is bed ridden.

14. BLOOD COLLECTION DEFINITION :- The surgical opening or puncture of a vein in order to withdraw blood. Person who perform phlebotomy is called a phlebotomy is called a phlebotomist.

15. TYPES OF BLOOD SAMPLES USED FOR DIFFERENT LABORATORY TEST WHOLE BLOOD SERUM PLASMA

16. STEPS OF SAFE BLOOD SAMPLING STEP 1:- Preparation of area STEP 2 :- Equipment selection STEP 3 :- Patient preparation and blood collection STEP 4 :- Transfer of blood sample STEP 5 :- Waste management

17. BLOOD TEST Preparation of articles and their purpose ARTICLES PURPOSE TORNIQUET TO MAKE THE VEINS PROMINENT SMALL MAKINTHOSH TO PREVENT SOILING OF BLOOD SYRINGE 5ML, OR 10ML TO COLLECT THE BLOOD NEEDLE (20gauge) TO PUNCTURE THE VEIN SPIRIT SWAB TO DISINFECT THE AREA DISPOSABLE GLOVES TO PREVENT CROSS INFECTION SPECIMEN CONTAINER ( TEST TUBE OR BOTTLE ) TO COLLECT THE SPECIMEN DRY COTTON SWAB TO APPLY GENTLE PRESSURE OVER THE PUNCTURE SITE AFTER SAMPLE COLLECTION ADHESIVE TAPE / PAPER TAPE TO ENSURE THE SWAB

18. STEPS OF PROCEDURE AND RATIONALE STEPS RATIONALE Check doctors order, explain procedure to the patient. To gain cooperation Wash hands and wear gloves To prevent infections Select and examine the vain To save time Instruct the patient to hold arm straight and fist clenched For easy access and to make vein prominent Apply the torniquet 5-15 cm above the selected site To make the vein prominent and visible Clean the site with spirit swab in circular motion To disinfect the area Fix chosen vein with thumb then insert the needle quickly and smoothly under the skin into the vein To acess vein for blood collection

19. Obtain blood sample by gently pulling plunger, release the tourniquet as soon as the sample is collected and instruct the patient to open the fist To prevent collapse of vein Apply sterile cotton swab to puncture site and with draw needle slowly. Secure swab with adhesive tape. To prevent leakage of blood Remove the needle from the syringe and eject the blood sample into the appropriate container. To prevent blood sample contamination Label specimen correctly and send to lab immediately with requisition form To avoid error Dispose the needle and syringe in appropriate container. Remove gloves and wash hands. To prevent cross infection

20. URINALYSIS

21. COLLECTION OF URINE URINE ANALYSIS DEFINITION :- Urine analysis is a procedure which includes the examination of color , appearence , odor , reaction, specific gravity, tests for sugar and bile and microscopic examination for pus, blod and casts. Sushma pandey

22. PRINCIPLE: Urine is one type of specimen that can be easily collected from a patient. Urinalysis testing can give the doctor valuable information about many body systems especially kidney function. The physician uses the information from urine testing to diagnose and treat many disease states.

23. TYPES OF URINE SPECIMENS RANDOM SPECIMENS CLEAN-CATCH SPECIMEN (MIDSTREAM) CATHETER SPECIMENS 12 or 24 HOURS SPECIMENS DOUBLE- VOIDED SPECIMEN

24. EQUIPMENT The following equipment is required: Sterile specimen pot . Sterile container with a wide top to collect the urine, which can then be transferred into a specimen pot. Soap and water, 0.9% sodium chloride solution or a disinfectant-free solution for genital hygiene; Gloves/plastic apron (if required); Appropriate forms/documentation

25. PREPARATION OF THE ARTICLES A try containing ARTICLES PURPOSE Specimen collection A sterile container A clean container A can For culture and sensitivity For urine examination For 24 hours urine collection A bed pan / urinal For bed ridden patients Disposable gloves To protect the hands from soiling Lab forms and patient labels To send specimen to the accurate place and avoid its misplacement A kidney try and paper bag To discard waste Soapy swabs, wet swabs and jug of water To clean perineum screen To provide privacy

26. PROCEDURE Patient preparation: For FEMALE patients : Move excessive betadine while keeping the labia separated. Wash hands thoroughly before beginning the procedure and put on disposable gloves. Use betadine swab to cleanse the perineal area. Separate the folds of the labia and wipe the betadine swab or Hibi clense from front to back (anterior to posterior) on one side, then discard swab. Using a second betadine swab or Hibiclens , wipe the other side from front to back, then discard. Using a third betadine swab or Hibiclens,wipe down the middle from front to back, then discard. Pat dry peri -urethral area with clean dry gauze.

27. For MALE patients: Wash hands thoroughly before beginning the procedure and put on disposable gloves.   If the patient is not circumcised, pull the fore skin back (retract the fore skin)on the penis to clean and hold it back during urination. Using a circular motion, clean the head of the penis with betadine swab or Hibi clens . Discard the swab or to welette .  

28. STEPS OF PROCEDURE Collection of midstream urine for culture and routine examination :- STEPS RATIONALE Assess client’s mobility