Transcript Specimen Collection Containers/Swabs a program for nurses Which one to use for Urine? Stool? Bacteriology Cultures? Virology Cultures? 7/09

Specimen Collection
Containers/Swabs
a program for nurses
Which one to use for
Urine?
Stool?
Bacteriology Cultures?
Virology Cultures?
7/09
1
Directions
• Carefully read through this program, paying
close attention to the pictures of the specimen
containers on each slide.
• When done, proceed to the quiz, by clicking on
the next button at the bottom of the screen.
• If you are connected to a color printer, print a
copy to use as a reference.
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Purpose
• This program is designed to provide the
nurse with information about, and
descriptions of, the correct containers to
use when collecting urine or stool
specimens as well as bacteriology and
virology cultures.
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Urine Containers
Which one to use?
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For U/A Chem-(Urinalysis)
This U/A straw transfer kit has a red/yellow
marble top tube and straw type adapter.
Use this tube for U/A Chem (Urinalysis)
testing only, as it contains a urine
preservative.
It cannot be used for any other test.
This tube comes in a kit with a straw type
adapter that allows you to draw the urine
up from a container such as a urine cup.
NOTE: This kit is NOT to be used for Urine
Cultures. The urine is not sterile.
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outside
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these
2 kits
BE BE
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2 kits
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these
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(U/A
Chem
andCulture
Urine
& Sensitivity)
(U/A
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Urine
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(U/A
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Urine
Culture
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For
Voided
U/A Chem
(Urinalysis)
For
Urine C/S
from
Catheter
BE VERY CAREFUL WHEN SELECTING A URINE KIT!
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For Urine Culture & Sensitivity
There are different types of Urine (C&S)
Culture kits:
1. Clean Catch Kit
It comes with a small gray top tube,
a cup, and 2 cleansing towelettes for
patient cleansing.
Use this kit if you are having your
patient collect a mid-stream sample
while urinating into the sterile cup.
Transfer the urine to the gray top
vacutainer tube using the port on the
top of the urine cup cap.
If less than 3mL of urine is collected,
keep the urine in the large screw cap
container and refrigerate. The gray
culture tube cannot be used if less
than 3mLs of urine are collected.
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Urine Culture & Sensitivity
continued….
2. Transfer Straw Kit
It comes with a small gray top tube
and a straw type adapter. Use the
tube from this kit if you are
collecting from an indwelling
urinary catheter (Foley).
To get the urine into the tube you
must use a vacutainer holder &
adapter* in order to draw the
sterile urine into the tube from the
port on the catheter tubing.
Remember to
use vacutainer
holder to
transfer urine
from foley to
this tube.
* kept with blood drawing supplies
The straw type adapter that comes with the
kit can be used with any type of STERILE
cup or container.
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Urine Culture & Sensitivity (C&S)
continued….
3. Non-Indwelling Urinary Catheter ‘Straight Cath’ Collection Kit
This is a kit that is specifically used for urine collection from a non- indwelling
urinary catheter. There is a collection tube (pictured below) that comes with the
kit that is sterile and can be used for Urine Culture and Sensitivity.
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Urine Culture & Sensitivity (C&S)
continued….
• Urine Cultures can only be taken from sterile
environments or from cups that are sterile.
• If you open a kit, but for some reason do not use all of
the parts - discard the unused parts in the garbage, so
no one inappropriately uses the left over pieces.
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Collecting Urine for a GC/Chlamydia
Amplified Antigen detection (Genprobe)
•
Used for the detection of GC/Chlamydia
Antigen from urine specimens.
•
Not to be confused with the swab kits used
for the amplified antigen detection from
genital specimens.
•
Kit includes a plastic pipette and specimen
container
•
Use the plastic pipette to transfer urine
from a collection container into the tube
provided in the kit and fill between the
black lines only.
•
Make sure to follow the instructions on the
kit for proper collection
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Do not use a serum (blood) gray top
tube for urine specimens
• Serum gray top tubes are
6.0mL and have a WHITE
label. They are for BLOOD
specimens only
• Urine culture tubes are
4.0mL and have a YELLOW
label. They are for URINE
specimens only
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For All Other Urine Tests
(not Urine C&S, or U/A Chem (Urinalysis))
• Used for all other Urine tests:
Lytes
Osmolarities
Protein
Creatinine
Urea Nitrogen
Legionella Antigen
HCG (Pregnancy)
Toxicologies
•Emergency
•Stat
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•Routine
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Stool Collection
• Stool (solid and liquid) should
be collected and placed in a
screw cap type container and
screwed shut tightly.
• These collection cups are used
for any type of bacterial
culturing and for viral testing
of Rotavirus and/or Adenovirus
Antigen.
!
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Either of these
cups is
acceptable for
use
NEVER place stool of any kind
in a denture cup and send to
the lab.
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Culture Swabs
Which One to Use?
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Bacterial or Viral??
• The next few slides will cover the various types of culture swabs,
media and containers for bacterial and viral culturing.
• There are many different types of cultures/swabs and it can be
confusing. When considering what swab/culture to use for viral
testing it may be easier to consider what virus is being tested for
and how (PCR* or NON-PCR) as many viruses can be cultured
using the same media.
• A chart of the various types of Specimen Collection
containers/swabs for Virology testing is available and has been
included in this presentation.
*Polymerase Chain Reaction-isolates DNA for certain viruses
• As always, if you are unsure of what to use, you can always call the
lab and ask.
• Microbiology – 626-7965
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• Virology – 878-7515
Red Top Culture Swab – Bacterial Testing
Used for most types of culturing
(except GC/Chlamydia)
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These are most commonly used for bacterial
culturing such as wounds, genitals, throats and
nares.
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Green Top Culture Swab – Bacterial Testing
These mini-tip culturettes are used for eye, and urethral
cultures or when a small area is being cultured for bacteria
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GenProbe Culture Swab Kit for Amplified Antigen
Detection of GC/Chlamydia
Use for GC/Chlamydia (Genital Specimens)
Kit contains swabs for cleansing area to be cultured (Red, Black & White package)
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• This is an
example of the
Virology Chart
that can be
referenced to
determine what
culture swab
you should use.
If your
department
does not have
one of these,
you can call
the Virology
Lab and
request one.
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Green Top Culture Swab
Used for Non-Culture Viral PCR* Testing Only
*Polymerase Chain Reaction-isolates DNA from certain viruses
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M4/UTM Media
Culture Swab
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Viral Culturing
• The containers to the left are used for
culturing of the following viruses:
–
–
–
–
–
–
–
UTM media (Pink
Fluid)
Spinal Fluid (CSF) in
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–
–
–
–
Chlamydia (VIRAL)
Herpes Simplex – (HSV)
Varicella Zoster
Viral Misc. Culture
Respiratory Virus
Enterovirus (CSF)
Respiratory Screen (influenza A&B,
Parainfluenza 1/2/3, Adenovirus, RSV Ag
IFA, and Human Meta Pneumovirus (hMPV))
Influenza A&B Ag IFA (influenza A&B Ag)
Adenovirus Ag IFA
Paraflu 1/2/3 Ag IFA
RSV Ag IFA
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Viral Culturing (cont)
•
The containers to the left are used for
culturing of the following virus:
– Cytomegalovirus (CMV) – NON PCR
• Urine would be placed in the blue cup
• Blood (serum) in the Green Top Tube
• Bronchial Wash, throat swab in the Pink
UTM Media
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Non Culture Viral PCR Testing
• The containers to the left are used for collection
for the following test:
– Bordetella pertussis DNA PCR
The Green Swab would be used for Nasopharyngeal
culturing
Nasopharyngeal suction secretions can be poured into the
Pink UTM Media
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Non Culture Viral PCR Testing (cont)
•
The containers to the left are used for collection for the
following tests:
– Enterovirus RNA PCR
• Nasopharyngeal secretions using the culturette
placed in Pink UTM media or using the Green
Culture Swab
• Spinal Fluid (CSF) – placed in clear plastic tube
– Herpes Simplex Virus (HSV) DNA PCR
– Varicella Zoster Virus (VZV) PCR
• Direct swab from a lesion, placed in Pink UTM
media or using the Green Culture Swab
• Spinal Fluid (CSF) – placed in clear plastic tube
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Non Culture Viral PCR Testing (cont)
• The containers to the left are used for
collection for the following tests:
– Cytomegalovirus (CMV) DNA PCR
• Whole Blood in either tube to the left
– Yellow top MUST be ACD not an SPS or SST
– Epstein Barr Virus (EBV) DNA PCR
• CSF in Clear plastic tube (not pictured)
• Whole Blood in either tube to the left
– Yellow top MUST be ACD not an SPS or SST
Purple Top EDTA Tube
Yellow ACD Tube
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