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
   Ensure a suitable location in which to carry out the procedure.
   To maintain patient privacy and dignity. E
3. 3.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).

Procedure

1. 4.Show
   Remove swab from outer packaging.
   To ensure collection of specimen material. E
2. 5.Show
   Pass the swab, with care, through the anus into the rectum and rotate gently.
   To avoid trauma and to ensure that a rectal, not an anal, sample is obtained. E
3. 6.Show
   If specimen is for suspected threadworm: take swab from the perianal area.
   Threadworms lay their ova on the perianal skin. E

Post‐procedure

1. 7.Show
   Remove cap from plastic transport tube.
   To avoid contamination of the swab. E
2. 8.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 viability of the sampled material during transportation. See manufacturer's guidance. E
3. 9.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. 10.Show
   Label swab immediately.
   To maintain accurate records and provide accurate information for laboratory analysis (NMC [165], C; Weston [255], E).
5. 11.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. 12.Show
   Arrange prompt delivery to the microbiology laboratory.
   To achieve optimal conditions for analysis (PHE [189], C).
7. 13.Show
   Document the procedure in the patient's records.
   To ensure timely and accurate record keeping (NMC [165], C).