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Microbiology 101 and Specimen Collection

Microbiology 101 and Specimen Collection. Sandy Villar NCA, ASCP Microbiology Supervisor ANMC. Transport of Specimens. All specimens transferred between rural clinic and ANMC are transported by Express Mail Or other designated courier systems

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Microbiology 101 and Specimen Collection

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  1. Microbiology 101 and Specimen Collection Sandy Villar NCA, ASCP Microbiology Supervisor ANMC

  2. Transport of Specimens All specimens transferred between rural clinic and ANMC are transported by Express Mail Or other designated courier systems All specimens are transported in accordance to the policy for Transportation of Dangerous Goods and Material

  3. Place all specimens in double biohazard zip-lock bags Tighten all specimen lids to avoid leakage Place biohazard bags into leak proof containers with absorbent Place vacutainer tubes or aliquot tubes into foam insert to avoid breakage Transport of Specimens

  4. Abscess/aspirates Blood culture C. difficile Chlamydia trachomatis Syringe/Sterile screw cap containe, plain red tube BacT-Alert bottle Sterile screw cap container Female and Male Gen-probe collection container Specimen and Container Types

  5. Fluids from sterile site Drainage, pus Group B Streptococcus Nasopharyngeal Sputum Stool culture Sterile screw cap container Swab in Stuarts transport media Swab in transport Stuarts media Sterile screw cap container Enteric Transport media Specimen and Container Types

  6. Stool Ova and Parasites Swabs for culture: GC Swabs for culture: wound,eye,vaginal, cervix,urethral throat PVA and formalin Swab in charcoal transport media Swab in Stuarts transport media Specimen and Collection Types

  7. Urine Culture Clean, sterile container if transport <2hrs Or grey-top preservative tube Specimen and Collection Types

  8. Specimen Rejection Criteria • Leaking Specimens • Unlabelled/Mislabelled Specimens • Incorrect collection container type • Sputum-not expectorated • Too old for culture

  9. Rejection of Specimens • Hemolysis: results from poor techniques or exposure to extreme heat or cold • Clotting: results from insufficient inverting • Improper tube collection • Underfilling or Overfilling of specimen container

  10. Unacceptable Specimens • Specimen contaminated with IV fluids • No label • Orders do not match specimen • No orders with specimen

  11. Specimen Handling Requirements • Fasting • Timed • Random • Iced/or at Cool Temperatures • Peak • Trough • Protect from Light

  12. Labeling Procedures/Proper Identification • All specimens require a proper label: • patient’s surname, first and middle, including Sr or Jr • patient’s hospital identification • or birth date • Note: both of the above MUST match the requisition form • date/time of collection • phlebotomist initials

  13. Proper labeling • Place patient label over preexisting blank label on evacuated tubes • Place patient label along the length of a microtainer tube, not obscuring the volume measurements

  14. Double bagging Recheck identification Sample + Requisition=proper handling Communicate to lab Tranporting Specimens

  15. Phlebotomy TechniquesGeneral steps • Call lab for clarification of orders • Organize equipment • Patient assessment • Greet patient • Proper identification • Position patient • Use Universal Precautions • Assemble equipment: proper equipment, order of draw • Select the best site • Be aware of complications • Proper preparation of site • Perform the venipuncture/release tourniquet • Control bleeding • Invert anticoagulated tubes • Properly label specimens at bedside/phlebotomy chair • Care of puncture site • Transport specimens to lab • Maintain aseptic techniques

  16. Medial Cubital Vein Size of Needle Allow the alcohol to Dry Skin is taut Four Secrets of Painless Venipuncture

  17. Specimen CollectionMinimize the Trauma of Phlebotomy“Strive to give your best first time, every time” • If your first puncture fails • Avoid trauma by asking for help • “thou shalt not dig for a vein” • Withdraw needle if experiencing excruciating pain • Withdraw needle if hematoma begins to form • Withdraw needle if patient begins to faint

  18. Vein location in arm

  19. Vein location in Hand

  20. Collection Complications • Uncooperative patient • Fainting • Edema • Mastectomy • Hematoma • Scarring/Burned area • Rash/hives

  21. Collection Complications • IV drug user • Obesity • Reasons for “short draw” • Reasons for no flow

  22. Step 1

  23. Step 2

  24. Step 3

  25. Step 4

  26. Step 5

  27. Step 6

  28. A problem is a chance for you to do your best Duke Ellington

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