Microbiology 101 and Specimen Collection

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Microbiology 101 and Specimen Collection

• Sandy Villar NCA, ASCP
• Microbiology Supervisor ANMC

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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

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Transport of Specimens

• 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

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Specimen and Container Types

• 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

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Specimen and Container Types

• 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

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Specimen and Collection Types

• 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

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Specimen and Collection Types

• Urine Culture

• Clean, sterile container if transport lt2hrs
• Or grey-top preservative tube

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Specimen Rejection Criteria

• Leaking Specimens
• Unlabelled/Mislabelled Specimens
• Incorrect collection container type
• Sputum-not expectorated
• Too old for culture

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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

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Unacceptable Specimens

• Specimen contaminated with IV fluids
• No label
• Orders do not match specimen
• No orders with specimen

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Specimen Handling Requirements

• Fasting
• Timed
• Random
• Iced/or at Cool Temperatures
• Peak
• Trough
• Protect from Light

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Labeling Procedures/Proper Identification

• All specimens require a proper label
• patients surname, first and middle, including Sr
  or Jr
• patients hospital identification
• or birth date
• Note both of the above MUST match the
  requisition form
• date/time of collection
• phlebotomist initials

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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

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Tranporting Specimens

• Double bagging
• Recheck identification
• Sample Requisitionproper handling
• Communicate to lab

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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

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Four Secrets of Painless Venipuncture

• Medial Cubital Vein
• Size of Needle

• Allow the alcohol to Dry
• Skin is taut

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Specimen CollectionMinimize the Trauma of
PhlebotomyStrive 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

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Vein location in arm
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Vein location in Hand
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Collection Complications

• Uncooperative patient
• Fainting
• Edema
• Mastectomy
• Hematoma
• Scarring/Burned area
• Rash/hives

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Collection Complications

• IV drug user
• Obesity
• Reasons for short draw
• Reasons for no flow

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Step 1
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Step 2
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Step 3
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Step 4
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Step 5
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Step 6
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• A problem is a chance for you to do your best
• Duke Ellington