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Culture - Nose, Throat, Eyes and Ears

Nursing Policy & Procedure Manual

Culture – Nose, Throat, Eyes, and Ears 

Purpose: 

To obtain a swab of infected material for microscopic examination to determine the disease-causing organism. 

Equipment: 

  • Sterile culture tube containing a sterile swab 

  • Flashlight 

  • Gloves 

Procedure: 

  1. Preparation: 

  • Ensure the physician has ordered the culture. 

  • Gather all necessary equipment. 

  1. General Steps: 

  • Put on gloves to maintain hygiene and prevent contamination. 

  • Use the flashlight to locate the irritated or discharging area. Do not cleanse the area before obtaining a swab for culture. 

  1. Swabbing Technique: 

  • Remove the swab from the tube by holding the tip of the swab opposite from the cotton end, being careful not to contaminate the swab. 

  • Direct the swab at the irritated or discharging area and rotate it gently over the area. 

  • Immediately replace the swab into the tube after collecting the sample. 

  1. Nose Culture: 

  • Insert the swab gently into the nostril. 

  • Rotate the swab against the nasal mucosa to collect the sample. 

  • Remove the swab and place it back into the sterile culture tube. 

  1. Throat Culture: 

  • Ask the resident to open their mouth wide and say "ahh." 

  • Use the flashlight to locate the irritated or discharging area at the back of the throat. 

  • Gently swab the area, avoiding contact with the tongue or teeth. 

  • Replace the swab into the sterile culture tube. 

  1. Eye Culture: 

  • Gently pull down the lower eyelid to expose the conjunctiva. 

  • Rotate the swab over the conjunctival surface, avoiding contact with the eyelashes. 

  • Replace the swab into the sterile culture tube. 

  1. Ear Culture: 

  • Use the flashlight to locate the irritated or discharging area in the ear canal. 

  • Gently insert the swab into the ear canal, avoiding contact with the external ear. 

  • Rotate the swab gently to collect the sample. 

  • Replace the swab into the sterile culture tube. 

  1. Labeling and Documentation: 

  • Label the specimen properly, clearly marking it as "Nasal," "Throat," "Eye," or "Ear" culture. 

  • Document the procedure in the resident's medical record, noting the site of the culture and any observations. 

Compliance and Documentation: 

  • Adhere to CMS guidelines and Requirements of Participation for Long-Term Care Facilities. 

  • Document the culture procedure, including the resident’s response and any observations, in their medical record. 

  • Note any abnormalities or difficulties encountered during the procedure. 

  • Regularly review and update techniques for obtaining cultures according to the latest clinical best practices and regulatory standards. 

  • Provide training to staff on proper culture collection procedures to ensure accurate results and resident safety. 

  • Conduct regular audits to ensure compliance with this policy and address any gaps in practice or documentation. 

References: 

  • Centers for Medicare & Medicaid Services (CMS). State Operations Manual (SOM), Appendix PP - Guidance to Surveyors for Long-Term Care Facilities. 

  • CMS Requirements of Participation for Nursing Homes. 

Tags
culture collection
Nursing Home
Resident Care
CMS Guidelines
State Operations Manual
SOM
Requirements of Participation
nursing home policy
Infection control
clinical procedures.
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