Box 1. Correct technique for collecting mid-stream urine specimens
Box 2. Correct technique for collecting urine specimens from a catheter
Box 3. Correct technique for performing a pus swab
Box 4. Correct technique for performing a blood culture
Optimal sampling is very important to increase yields and decrease contamination rates (see boxes below). Surgical specimens from abnormal structures such as abscesses should usually be collected at the time of operation. Once surgical drains are placed they quickly become colonised with skin and environmental bacteria and culture results are not interpretable. Pus swabs collected outside of theatre are discouraged, as it is extremely rare for them to yield information that will change patient management.
Box 1. Correct technique for collecting mid-stream urine specimens
Instructions for collection of urine specimens
Females
- Wash your hands
- Clean the vulva front to back with sterile gauze and sterile water
- Spread labia with fingers
- Void and collect urine mid‐flow
Males
- Wash your hands
- Retract foreskin and wash glans with sterile gauze and sterile water
- Void and collect urine mid-flow
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Box 2. Correct technique for collecting urine specimens from a catheter
- Use aseptic technique with sterile gloves and apron
- Clamp tubing just distal to sampling port
- Wait for urine to collect above clamp
- Wipe sampling port with cleaning solution
- Remove urine with a small gauge sterile needle and syringe
- Transfer urine to sterile container
- Clean port again
- Unclamp tubing
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Box 3. Correct technique for performing a pus swab
- Wounds with slough, necrotic tissue, or dried exudate should first be debrided
- Wash the wound with sterile saline
- If the wound is dry moisten the tip of the swab with sterile saline
- Move swab tip across the wound surface in a zig-zag motion at the same time as being rotated between the fingers
- Apply gentle pressure to release fluid from the base of the wound
- Aim to include as much of the area of the wound as possible but avoid intact skin around the wound
- Document clinical information on laboratory request form
- Transfer to laboratory as soon as possible
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Box 4. Correct technique for performing a blood culture
- Verify the patient’s identity and obtain verbal consent.
- Assemble the correct materials required for blood culture:
- blood culture bottle(s)
- syringe (10 ml or more)
- needle (22 gauge or more)
- sterile gloves
- tourniquet
- adhesive strip
- cleaning solution*
- sterile pack containing cotton/gauze swabs, sterile paper x 2 and waste bag
- patient labels
- sharps waste disposal bin
- Apply tourniquet and select a suitable vein
- Wash hands and apply sterile gloves
- Clean the puncture site with cleaning solution using aseptic technique and allow 30 seconds for the disinfectant to dry
- Place green sterile cover with opening over site for blood culture
- Collect 10ml of blood per bottle from adults
- Release tourniquet and remove needle
- If not using the vacutainer system, disinfect the top of the blood culture bottle before inoculating blood
- Do not change needles between blood sample collection and inoculation of blood culture bottle
- Always fill blood culture bottle before filling vials for other tests
- Label the blood culture bottle making sure not to cover the bar code label or the bottom of the bottle
- Complete a laboratory request form in full
- If there is a delay in getting the sample to the laboratory, do not refrigerate the bottle; rather leave it at room temperature
- Document in the notes, the date and time that the blood culture was taken
*Chlorhexidine‐alcohol is recommended, but if using povidone iodine, it must be left to dry for at least 1 minute prior to performing culture |