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
   Remove current dressing, if applicable.
   To expose the wound in preparation for swabbing. E
4. 4.Show
   Remove gloves and decontaminate hands. Open sterile dressing pack, decant sterile swab and put on sterile gloves.
   To reduce the risk of cross‐infection (RCN [200], E) and prepare equipment for sampling (NHS England and NHSI [155], C).

Procedure

1. 5.Show
   Remove swab from outer packaging.
   To ensure collection of specimen material. E
2. 6.Show
   Rotate the swab tip over a 1 cm² area of viable tissue, at or near the centre of the wound, for 5 seconds, applying enough pressure to express tissue fluid from the wound bed.
   Expressed tissue fluids are likely to contain the true infecting organisms and less likely to contain surface contaminants (Huddleston Cross [97], E).
3. 7.Show
   If the wound is dry, the tip of the swab should be moistened with 0.9% sodium chloride.
   To make the swab more absorbent and to increase the survival of pathogens present prior to culture (Huddleston Cross [97], E).
4. 8.Show
   If pus is present, it should be aspirated using a sterile syringe and decanted into a sterile specimen pot.
   To yield the optimum number of micro‐organisms present within the wound (Weston [255], E).

Post‐procedure

1. 9.Show
   Remove cap from plastic transport tube.
   To avoid contamination of the swab. E
2. 10.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. 11.Show
   Redress the wound, if applicable, as per patient care plan.
   To redress the wound. E
4. 12.Show
   Remove gloves and apron, discard all clinical waste and wash and/or decontaminate hands.
   To reduce the risk of cross‐infection (NHS England and NHSI [155], C).
5. 13.Show
   Label swab immediately.
   To maintain accurate records and provide accurate information for laboratory analysis (NMC [165], C; Weston [255], E).
6. 14.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).
7. 15.Show
   Arrange prompt delivery to the microbiology laboratory (keep at room temperature).
   To achieve optimal conditions for analysis (PHE [189], C).
8. 16.Show
   Document the procedure in the patient's records.
   To ensure timely and accurate record keeping (NMC [165], C).