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
   Ask the patient to defaecate into a clinically clean bedpan or receiver.
   To avoid unnecessary contamination from other organisms. E
2. 4.Show
   If the patient has been incontinent: a sample may be obtained from bedlinen or pads; try to avoid contamination with urine.
   Urine would cause contamination of the sample (Higgins [86], E).
3. 5.Show
   Using the integrated spoon, scoop enough faecal material to fill a third of the specimen container (or 10–15 mL of liquid stool).
   To obtain a suitable amount of specimen for laboratory analysis. E
4. 6.Show
   Apply specimen container lid securely.
   To prevent risk of spillage. E

Post‐procedure

1. 7.Show
   Dispose of waste, remove apron and gloves, and wash hands with soap and water.
   To reduce the risk of cross‐infection (DH [48], C). Soap and water must be used as alcohol‐based handrub is ineffective for C. difficile (DH 2010, C).
2. 8.Show
   Examine the specimen for features such as colour, consistency and odour. Record observations in nursing notes and/or care plans.
   To complete a comprehensive nursing assessment (NMC [165], C; WHO [260], C).
3. 9.Show
   In cases of suspected tapeworm: segments of tapeworm are easily seen in faeces and should be sent to the laboratory for identification.
   Unless the head is dislodged, the tapeworm will continue to grow. Laboratory confirmation of the presence of the head is essential (Gould and Brooker [75], E).
4. 10.Show
   Label the sample and complete the microbiology request form (including relevant information such as onset and duration of diarrhoea, fever or recent foreign travel).
   To maintain accurate records and provide accurate information for laboratory analysis (NMC [165], C; Weston [255], E).
5. 11.Show
   Dispatch sample to the laboratory as soon as possible or refrigerate at 4–8°C and dispatch within 12 hours.
   To increase the chance of accurate organism identification and to ensure the best possible conditions for laboratory analysis (Higgins [84], E).
6. 12.Show
   In cases of suspected amoebic dysentery: dispatch the sample to the laboratory immediately.
   The parasite causing amoebiasis must be identified when mobile and survives for a short period only. Therefore, faeces should remain fresh and warm (Kyle [121], E).
7. 13.Show
   In cases of prolonged diarrhoea, especially in the presence of a fever: dispatch the sample to the laboratory immediately.
   Due to the risk of C. difficile and to ensure prompt diagnosis and initiation of appropriate infection control measures (DH 2010, C).
8. 14.Show
   Document the procedure in the patient's records.
   To ensure timely and accurate record keeping (NMC [165], C).