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).

Procedure

1. 3.Show
   Remove swab from outer packaging.
   To ensure collection of specimen material. E
2. 4.Show
   For cutaneous sampling (for screening, e.g. groin): moisten swab with sterile saline and roll one swab along the area of skin along the inside of the thighs close to the genitalia.
   Organisms adhere more easily to a moist swab (Hampson [81], C).
3. 5.Show
   For suspected fungal infection: skin scrapings should be obtained. Take a scalpel blade and, with the affected area of skin stretched taut between two fingers, gently scrape the skin with a piece of dark paper underneath. Do not cause bleeding.
   To identify superficial fungi that inhabit the outer layer of the skin (MacKie [131], E). To visualize the amount of sample and to allow easier transfer. E

Post‐procedure

1. 6.Show
   Either:

   For swab specimen:

   • Remove cap from plastic transport tube.
   • 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
   Or:

   For skin scrapings:

   • Transfer scrapings into sterile container.
   To allow samples to be processed appropriately in the laboratory. E
2. 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).
3. 8.Show
   Label swabs immediately.
   To maintain accurate records and provide accurate information for laboratory analysis (NMC [165], C; Weston [255], E).
4. 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).
5. 10.Show
   Arrange prompt delivery to the microbiology laboratory (keep at room temperature).
   To achieve optimal conditions for analysis (PHE [189], C).
6. 11.Show
   Document the procedure in the patient's records.
   To ensure timely and accurate record keeping (NMC [165], C).