Sample or Specimen Collection | CHAPTER 12 | Microbiology & Parasitology for Nurses

Sample or Specimen Collection – Basic microbiology, parasitology, and immunology; nature, reproduction, growth, and transmission of common microorganisms and parasites in Bangladesh; prevention including universal precaution and immunization, control, sterilization, and disinfection; and specimen collections and examination. Students will have an understanding of common organisms and parasites caused human diseases and acquire knowledge about the prevention and control of those organisms.

Sample or Specimen Collection

Definition of Specimen

A specimen may be defined as a small quality of a substance or which shows the kind and quality of the sample.

Or

A specimen of anything that is selected for diagnosis examination study or testing.

Or

A specimen is a small quantity of a substance which is collected for investigation purposes and this sample shows the kind and quality of the whole substances.

Definition of Specimen Collection

Specimen collection is the collection of a required amount of tissue or fluid for laboratory examination is called specimen collection.

Or

The collection of tissue or body fluids for laboratory investigations to aid diagnosis and/orb treatment of medical conditions.

Purpose/Importance of Specimen Collection

1. To collect a specimen of body discharges or excreta for examination.

2. To aid the doctor is diagnosing and treating the disease.mu

3. To detect any abnormalities.

4. To identify the disease and nature of disease

5. To determine the cause for treatment.

6. To note the progress of disease

Indication of Specimen Collection

1. Microbiological.

2. Biochemical and

3. Other laboratory investigations are indicated

Specimen collection offers the first crucial step in investigations that define the nature of the disease and determine diagnosis and the mode of treatment.

Principles of Specimen Collection

1. The patient should be intimated will in advance regarding the procedure and sample of specimen.

2. The specimen container should be clean.

3. Every specimen should be separately labeled clearly with patient’s name, bed number, reg. number, ward number, etc. and nature of specimen with nurse’s signature and date or time of collection etc.

4. All specimens duly labeled should be kept in separate tray for dispatching to lab.

5. Morning specimens should be collected by the night nurse on duty. Other samples should be collected by day-nurse only.

6. Any special instruction for special test should be noted by nurse in nursing lab not book and instructions is followed accordingly.

Types of Specimen

There are mainly two types of specimen :

1. Routine examination.

2. Special examination.

Rules of Specimen Collection

1. The specimen must be collected from right person.

2. Kinds of specimen should be collected as by doctor’s order.

3. Adequate amount should be collected according to nature of test.

4. The container must be sterile for collection of any specimen and free from outside contaminated.

5. Use cial container for some specimen such as fasting blood sugar, random blood sugar, blood for electrolytes etc.

6. Correctly fill a label and attach it to the container.

• Name and age of patient.
• Registration number.
• Bed no.
• Ward no.
• Unit no.
• Date or Time.
• The nature of test.

Time of specimen collection

• Usually early in the morning. (Stool, Urine)
• Before washing of mouth-Oral swab, throat swab.
• Specific instruction-fasting blood sugar Collects early in the morning during fasting period.

Blood Collection

Definition of Blood:

Blood may be defined as the familiar red fluid in the body that contains white and red blood cells, platelets, proteins, and other elements. The blood is transported throughout the body by the circulatory system.

Function of Blood

Blood has three main functions:

1. Transport,

2. Protection and

3. Regulation.

A. Transport

Blood transports the following substances:

• Gases, namely oxygen (O2) and carbon dioxide (CO2), between the lungs and rest of the body
• Nutrients from the digestive tract and storage sites to the rest of the body
• Waste products to be detoxified or removed by the liver and kidneys
• Hormones from the glands in which they are produced to their target cells
• Heat to the skin so as to help regulate body temperature

B. Protection

Blood has several roles in inflammation:

• Leukocytes, or white blood cells, destroy invading microorganisms and cancer cells
• Antibodies and other proteins destroy pathogenic substances
• Platelet factors initiate blood clotting and help minimise blood loss

C. Regulation

Blood helps regulate:

• pH by interacting with acids and bases
• Water balance by transferring water to and from tissues

Properties of Blood

Definition of Blood Collection

The taking of a blood sample to determine its character as a whole, to identify levels of its component cells, chemicals, gases, or other constituents, to perform pathological examination, etc.

Common Sites of Blood Collection

Procedure of Blood Specimen Collection for Routine Examination

C. Materials:

• Tourniquet.
• Small mackintosh.
• Syringes: 3ml 5ml, 10ml.
• No. 20 Gauge needles.
• Alcohol swabs.
• Disposable gloves.
• Specimen container- test tube or bottle.
• Laboratory requisition form
• Sterile gauze pads (2″ x 2″)
• Adhesive tap

D. Procedure:

1. Check the physician’s order, progress, notes, and nursing care plan.

2. Identify the patient

3. Explain the procedure to the patient.

4. Collect and prepare equipment. 10

5. Ensure patient’s privacy.

6. Wash and dry hands.

7. Put on clean, disposable gloves.

8. To avoid hemolysis, the needle used for venepuncture should have a short bevel, the syringe and needle must be dry, and the container into which the specimen is placed must be dry.

9. For some tests whole, clotted blood is required, whilst for others it should be anti- coagulated, so that the laboratory may obtain the fraction of the blood for examination that they require.

10. Each laboratory should issue specimen bottles containing the correct anticoagulant for each test, with instructions as to the quantity of blood required.niqza

11. Heparin, potassium oxalate and sodium citrate are fairly common anticoagulants.

12. For blood sugar estimation fluoride is added to the tube to prevent the disappearance of the sugar from the bloodia

13. Once the blood has been added to the anti-coagulant, it must be inverted gently so that it is thoroughly mixed with the specimen.

14. When sending blood for examination, care must be taken to avoid haemolysis of the specimen, for haemolysis renders the specimen useless.

15. Shaking causes haemolysis.

16. Document the procedure appropriately

Urine Collection

Urine is the liquid waste produced by the kidneys. Urine is a clear, transparent fluid that normally has an amber color. The average amount of urine excreted in 24 hours is between 5 to 8 cups or 40 and 60 ounces.

Or

The fluid secretion from the body by the kidneys stored in the bladder and discharges usually voluntarily through the urethra.

Physical Characteristics of Normal Urine

Procedure of Urine Collection for Routine Examination

C. Equipment:

• Clean, wide mouthed container.
• Laboratory requisition form.
• Bed pan or urinal.
• Soap and water.
• Appropriate laboratory form.
• Gloves.

D. Procedure:

• Check the physician order and nursing care plan.
• Identify the patient.
• Explain procedure to the patient with specific instructions about washing the genital area (skin around the urethra meatus) with soap and water and give the labeled container. Instruct patient not wet the label on the outside.
• Ask the patient to direct the first and last part of the urine stream into a urinal or toilet and to collect the middle part of the stream into the special container.
• Have the patient place the specimen container in proper / designated
• With gloved hand place the specimen container in polythene bag. place.
• Send specimen to the laboratory with completed, signed laboratory form.
• Remove gloves and wash hands.
• Record the procedure in the nurse’s notes and other appropriate forms.

Stool Collection

Procedure of Urine Collecting For Routine Examination

C. Articles:

• A clean specimen container.
• A spatula for putting the specimen into the container.
• Dry bed pan (for helpless patients). Additional bedpan for rinsing and cleaning.
• Laboratory requisition form.
• Clean gloves.
• Waste paper (for wrapping used spatula).
• A pitcher of water (for helpless patient).
• Tissue/towel.

D. Procedure:

• Check the physicians order.
• Identify the patient.
• Explain to patient the procedure and make clear what is expected of him/her.
• Give the labeled container and spatula to the patient with instructions:
• To defecate into clean bedpan.
• Not to contaminate specimen with urine.
• Don gloves.
• For helpless patient: assist patient on to the clean bedpan.
• Leave him with instructions.
• When done, remove and keep aside the bedpan after placing the second one for cleansing.
• Once the specimen is collected sent it to lab with the appropriate requisition forms.
• Wash and replace the reusable articles
• Dispose of the used spatula wrapped in waste paper
• Wash and dry hands.
• Record information in the patient’s chart

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