Pre‐procedure

ActionRationale

1. 1.Show
   Introduce yourself to the patient, explain and discuss the procedure with them, and gain their consent to proceed.
   To ensure that the patient feels at ease, understands the procedure and gives their valid consent (NMC [165], C).
2. 2.Show
   Wash hands with bactericidal soap and water, or decontaminate physically clean hands with an alcohol‐based handrub. Put on apron and gloves.
   To reduce the risk of cross‐infection and specimen contamination (NHS England and NHSI [155], C).
3. 3.Show
   Ensure no antibiotics or other therapeutic drops have been used in the aural region within the 3 hours before taking the swab.
   To prevent collection of such therapeutic agents, which may mask pathogenic organisms and invalidate the specimen. E

Procedure

1. 4.Show
   Remove the swab from outer packaging and place at the entrance of the auditory meatus, as shown in Action figure 13.22. Rotate gently once.
   To avoid trauma to the ear and to collect secretions and/or suitable specimen material. E

Post‐procedure

1. 5.Show
   Remove cap from plastic transport tube.
   To avoid contamination of the swab and to maintain the viability of the sampled material during transportation. E
2. 6.Show
   Carefully place swab into plastic transport tube, ensuring it is fully immersed in the transport medium. Ensure cap is firmly secured.
   To avoid contamination of the swab and to maintain the viability of the sampled material during transportation. See manufacturer's guidance. E
3. 7.Show
   Remove gloves and apron, and wash and/or decontaminate hands.
   To reduce the risk of cross‐infection (NHS England and NHSI [155], C).
4. 8.Show
   Label swab immediately.
   To maintain accurate records and provide accurate information for laboratory analysis (NMC [165], C; Weston [255], E).
5. 9.Show
   Complete microbiology request form (including relevant information, such as exact site, nature of specimen and investigation required).
   To maintain accurate records and provide accurate information for laboratory analysis (NMC [165], C; Weston [255], E).
6. 10.Show
   Arrange prompt delivery to the microbiology laboratory or refrigerate at 4–8°C.
   To achieve optimal conditions for analysis (PHE [189], C).
7. 11.Show
   Document the procedure in the patient's records.
   To ensure timely and accurate record keeping (NMC [165], C).