COLLECTING SPECIMENS SHARON HARVEY

SPECIMENS ANY BODY TISSUE CAN HAVE A SPECIMEN TAKEN FROM IT THE MOST COMMON SPECIMENS INCLUDE: BLOOD URINE FAECES WOUND /SKIN

FAECAL SPECIMENS Used to detect bacterial, viral or parasitic infections. Faecal Occult Blood Test (FOB) is used to detect traces of blood that are invisible to the naked eye.

FAECAL SAMPLING Ensure to protect yourself with an apron and clean gloves Universal precautions apply Either instruct the patient to catch part of the faeces on toilet paper without letting it fall into the water of the toilet pan Or use a bed pan Unscrew the lid of the specimen pot Using the spoon attached to the lid scoop a piece of faeces about the size of a walnut, or in the case of diarrhoea enough faeces to cover the scoop and place into the pot

FAECAL SAMPLING Discard any remaining faeces Ensure correct patient information is on form and specimen pot Place the specimen pot inside the sealable pocket and the form in the other pocket of the plastic bag The sample should be sent to the pathology laboratory together with the request form as soon as possible. Documentation should be completed

URINE SPECIMENS SPECIMEN TYPES RANDOM SPECIMEN For chemical and microscopic examination. Can be collected at unspecified times and is often more convenient for the patient. A random specimen is suitable for most screening purposes. FIRST MORNING SPECIMEN OR 8 HOUR SPECIMEN The patient should be instructed to collect the specimen immediately upon rising from a night’s sleep. This type of specimen is best for testing for pregnancy, as the urine is more concentrated.

URINE SPECIMENS FASTING SPECIMEN this differs from a first morning specimen by being the second voided specimen after a period of fasting GLUCOSE TOLERANCE TEST SPECIMEN These are specimens collected to correspond with the blood samples drawn during a glucose tolerance test. The number of specimens varies with the length of the test.

URINE SPECIMENS 24 HOUR SPECIMEN To obtain an accurately timed specimen, it is necessary to begin and end the collection period with an empty bladder. The following instructions for collecting 24-hour specimen can be applied to any timed collection: Day 7 ampatient voids and discards specimen. Patient collects all urine for the next 24 hours Day 7 ampatient voids and adds this urine to the previously collected urine

URINE SPECIMENS CATHETERISED SPECIMEN This specimen is collected under sterile conditions by passing a hollow tube through the urethra into the bladder. If there is an indwelling catheter insitu, the catheter has a sampling port, which should be swabbed, and a syringe attached to aspirate urine from the catheter. Do not obtain the specimen from the catheter bag.

URINE SPECIMENS MID STREAM “CLEAN CATCH” SPECIMEN This specimen provides a safer less traumatic method for obtaining urine for bacterial culture. It also offers a more representative and less contaminated specimen for microscopic analysis than the random specimen. Adequate cleansing materials and a sterile container must be provided for the patient. The procedure for the collection of a mid stream urine specimen

URINE SPECIMENS SUPRAPUBIC ASPIRATION Urine may be collected by external introduction of a needle into the bladder. It is free from extraneous contamination and may be used for cytologic examination. 12mls of urine should be submitted for any type of urinanalysis and should be transported as soon as possible to the pathology laboratory.

BLOOD SPECIMENS A large number of laboratory tests are widely available. However, not all blood tests are available in all hospitals. Some blood tests are so specialized that they have to be sent to hospitals such as the Heath in Cardiff or elsewhere.

BLOOD SPECIMENS Most blood tests fall within one of two categories: screening or diagnostic Screening tests are used to try to detect a disease when there is little or no evidence that a person has a suspected disease e.g. measuring cholesterol levels helps to identify one of the risk factors of heart disease. Diagnostic tests are used when a specific disease is suspected to verify the presence and the severity of that disease.

MOST COMMON BLOOD TESTS Full Blood Count (FBC) Urea and Electrolytes (U&E) Coagulation screen Fasting Glucose Lipids Troponin T or I Blood cultures Arterial blood gas

SKIN OR WOUND SPECIMENS Optimal time of specimen collection is before antimicrobial therapy is commenced Samples of pus are preferred to swabs if possible, however if there is little pus or exudates then swabs are acceptable Swabbing dry crusty wounds is unlikely to detect any infections Specimens should be transported as soon as possible

SKIN OR WOUND SPECIMENS If dry areas are to be swabbed e.g. MRSA screening the tip of the swab should be soaked in sodium chloride (NACL) If moist area are to be swabbed e.g. oral mucosa or nasal mucosa the tip of the swab does not need to be soaked in NACL

DOCUMENTATION The following information needs to be written on the form: o Name o Date of birth o Address o Sex o GP or ward o Specimen type o Test required

DOCUMENTATION The following information needs to be written on the pot: o Date specimen taken o Name o Date of birth o Type of specimen o Ward

DOCUMENTATION Any sample taken from a patient should be recorded in the nursing kardex or specified form in order to keep an accurate record of what samples are taken and when the samples were taken so that results can be tracked