Culture - Nose, Throat, Eyes and Ears

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. 

2. 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. 

3. 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. 

4. 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. 

5. 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. 

6. 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. 

7. 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. 

8. 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.