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 and to help her to relax and be comfortable during the procedure. 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).
4. 4.Show
   Position the patient with her knees bent and legs apart. Adjust the light.
   To be able to visualize the vulva and cervix. E

Procedure

1. 5.Show
   Remove swab from outer packaging.
   To ensure collection of specimen material. E
2. 6.Show
   Either:

   For low vaginal swab: insert the swab into the lower part of the vagina and rotate gently but firmly.
   To obtain appropriate sample. E
   Or:

   For high vaginal swab: moisten the speculum with warm water and insert into the vagina to separate the vaginal walls. Wipe away any excess cervical mucus with a cotton swab. Using a sterile swab, sample as high as possible in the vaginal vault. Remove the speculum and wipe the vagina and vulval area with a tissue.
   To ensure maximum visibility of the area to be swabbed and to obtain the appropriate sample. E
3. 7.Show
   Allow the patient to resume a comfortable position.
   To aid patient comfort. E

Post‐procedure

1. 8.Show
   Remove cap from plastic transport tube.
   To avoid contamination of the swab. E
2. 9.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. 10.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. 11.Show
   Label swab immediately.
   To maintain accurate records and provide accurate information for laboratory analysis (NMC [165], C; Weston [255], E).
5. 12.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. 13.Show
   Arrange prompt delivery to the microbiology laboratory (within 4 hours).
   To achieve optimal conditions for analysis (PHE [189], C).
7. 14.Show
   Document the procedure in the patient's records.
   To ensure timely and accurate record keeping (NMC [165], C).