2. Specimens allowed to stand at the room temperature for a long time will give a false result due to
Actions: Specimens should be always fresh for the laboratory examination. Send the specimens to the laboratory as soon as they are collected. The motility of the organism can be noted only when they are fresh.
Principle: Decomposition of specimen. Multiplication of undesirable bacteria. Destruction of pathogenic bacteria.
Actions: Bacteria multiply at the room temperature. So, the specimens which are not tested immediately are kept in the refrigerator, because cold temperature inhibits the growth of bacteria.
Sometimes, it is necessary to add preservatives to the urine to prevent decomposition of urine. E.g. when collecting 24 hours urine specimen.
3. Blood chemistry is not uniform throughout the day, it varies with the food intake.
Actions: for a diabetic client, it is necessary to collect urine specimen several times a day so as to help the doctor to regulate the insulin dosage. Usually the urine specimens are collected just before meal times. E.g. 7 A.M., 12 Noon, 4 P.M. and 9 P.M.
Fasting blood specimens are collected to test the blood for chemical analysts. E.g. fasting blood is collected for blood sugar , cholesterol and blood proteins etc.
4. The accuracy and reliability of findings depend upon the correct method of collection, transportation of the specimens to the laboratory and recording of reports. Inaccurate results may mislead the physician in the diagnosis and treatment of clients.
Actions: label each specimen as soon as it is received with the necessary data such as
Name of the client
Name of Specimen
Nature of test to be done
Date of Collection
Send the specimens with the requisition form duly filled and signed.
Specimens are not to be misplaced. Send them to the proper place.
Record the reports immediately and correctly on the client’s charts.
5. Specimens serve as a media for transmission of disease producing organisms to the personnel who handle them carelessly.
Actions: when giving the container, explain to the client not to contaminate the outside of the container with the specimens, because it will contaminate the hands of those who handle them.
Transmission of parasites and other organisms may take place through the infected hands. Therefore, care should be taken to prevent contamination of hands while collecting and transporting the specimens to the laboratory. Carry the specimens in trays rather than in hands.
Insist the client and the personnel to wash hands thoroughly after handling the specimen bottles.
Containers should have a wide mouth to prevent spilling of the specimens on the outer side of the bottle.
Containers of the proper sizes are used according to the nature of specimen. E.g. a large jar is used when collecting 24 hours of urine specimen.
The containers once used are cleaned and autoclaved before they are reused.
Wax lined disposable paper cups are used for the collection of sputum and stool specimens, because they are safely disposed after use.
There should be no cracks in the specimen bottles. The specimen may leak outside.
COLLECTION OF SPECIMENS – NURSES ROLE AND RESPONSIBILITY
Preparation of Client:
Working Knowledge of diagnostic test
Nurse need to explain the test with clarity and compassion.
Nurse need to explain the purpose of the test.
While assisting the physician with a test, talk to the client throughout the test, to comfort and encourage him/her.
After test is over, observe the client for any untoward reactions of complications and be prepared to implement appropriate care.
On the previous day, explain the procedure to the client. Explain what specimen to collect, when to collect, how to collect and the amount to be collected. Provide an appropriate container and demonstrate to the client how to use it.
Instruct the client not to contaminate the outside of the bottle.
Proper collection of specimens not only helps to ensure accurate test results, but also protects the client and the nurse. Nurse must see that they use gloves and other barriers as necessary. Before the nurse is exposed to the client’s body fluid, she should make sure to observe the appropriate precautions.
Preparation of the Equipment:
All specimens are to be collected in clear and dry containers. Use containers with wide mouth. Sterile containers are used to collect specimen for culture. Wax lined disposable cups are used for the collection of sputum and stool specimens. Large containers are used to collect 24 hours urine specimen. Sterile test tubes are used to collect fluids. Clean slides are used to collect smears. No antiseptic solution should be present in the specimen bottles as they may hamper the growth of microorganisms and thus obscure the results.
Soon after the collection of the specimen, it must be labeled clearly with the client’s identification data, date and time of collection and should be followed by request form duly filled and signed by the nurse who sends the specimen for examination. It must be
documented in the client’s record.
Specimen collection is an art which can directly affect a client’s diagnosis, treatment and recovery. The nurse is the sole responsible person for the collection of specimens. In some situation, the nurse may have to schedule the test, prepare the client, assist the physician in performing the test and give after care of the client.
Collection of Specimen:
A specimen may be defined as a small quantity of a substance or object which shows the kind and quality of the whole sample.
Principle of Specimen Collection:
1. Contaminated and improperly collected specimens will produce false results which will adversely affect in the diagnosis and treatment of clients.
Actions: Give adequate explanations regarding the collection of specimens. Explain to the client. When to collect, what to collect. How to collect and the quantity to be collected.
Ask the client to wash the external genital area with soap and water and then rinse with water alone before collecting urine specimens.
Equipment used for the collection of specimens should be clean and dry.
No antiseptic should be present in the specimen bottle.
As far as possible morning specimens are collected.
If a culture specimen is required – use sterile containers, get midstream specimen or catherized specimen in case of urine specimen. Avoid collecting specimen during menstruation. The inside of the container should not be contaminated with the fingers of the nurses or clients before or after collecting the specimens. The lid of the container should be removed and placed in such a way that the inner surface should not be contaminated. Open the container just before collecting the specimen and close it immediately after collecting the specimen.
PRINCIPLES OF SPECIMEN COLLECTION AND NURSES RESPONSIBLILITY – A SIMPLE NURSING PROCEDURE
AUTHOR: SUMANA BISTA