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UWHC,

Policies,Clinical,UWHC Clinical,Department Specific,Nursing Patient Care,Diagnostic Tests and Procedures

Collection of Stool Specimens for Laboratory Examination (Including Ova and Parasites)(Adult & Pediatric) (11.14-AP)

Collection of Stool Specimens for Laboratory Examination (Including Ova and Parasites)(Adult & Pediatric) (11.14-AP) - Policies, Clinical, UWHC Clinical, Department Specific, Nursing Patient Care, Diagnostic Tests and Procedures

11.14-AP

NURSING PATIENT CARE POLICY & PROCEDURE

I. PURPOSE

To provide guidance and direction for the collection of stool specimens for laboratory
examination. Also see Lab Test Directory (found on U-Connect).

II. POLICY
A. A valid order from an authorizing provider is required for all testing.
B. Collect stool specimen in a clean, dry, leak-proof container for bacterial and viral
cultures, Clostridium difficile assays, fecal leukocyte and other fecal analysis.
C. When collecting all stool samples: For container and transport information refer to
the individual entries in the Lab Test Directory.
III. PROCEDURE
A. Collection of Stool for Bacterial and Viral Cultures, Clostridium Difficile Assays,
and Other Fecal Analyses
1. Limitations and notes on testing
a. Specimens for stool culture on patients hospitalized more than 3 days
are not acceptable. There are no exceptions.
b. Only one specimen for stool culture every 24 hours.
c. There is no general recommendation that multiple specimens be
submitted for diagnosis unless cultures are negative in the presence of
persistent symptoms. That is, preorders for cultures x 3 are not
routinely warranted. See Lab Test Directory for specific restrictions.
d. A single stool specimen may be collected for screening or diagnostic
occult blood (using Polymedco iFOB Complete Collection Tube) on
the nursing unit and sent to laboratory for testing.
2. Equipment
a. Bedpan
b. Toilet tissue
c. Health Link order or Laboratory Requisition form
d. Patient labels
e. Elastic band
f. Marking pen
g. Tongue depressor
h. Clean gloves
3. Collect stool in clean, dry, leak-proof container. Avoid contamination with
urine or water. Specimen to be collected from a clean area; i.e. diaper, hat,
bedpan or clean linen.




Effective Date:
October 27, 2017

Administrative Manual
Nursing Manual (Red)
Other ______________

Policy #: 11.14AP

Original
Revision

Page
1
of 3

Title: Collection of Stool Specimens for
Laboratory Examination (Including Ova
and Parasites) (Adult & Pediatric)

Page 2 of 3

a. Label container according to Clinical Laboratories Policy 1502.5.06,
Acceptance Policy for Specimen Identification
b. If necessary, physician may order a suppository or saline enema to
obtain a specimen.
c. If unable to obtain stool, a CultureSwab
®
inserted into the rectum may
be used as a specimen, unless contraindicated by patient condition.
Specimen must be transported to UW Health Microbiology at room
temperature within 2 hours of collection. This is a much less desirable
specimen. Rectal swabs are acceptable only for bacterial and viral
culture. The rectal swab must show feces.
4. Perform hand hygiene according to UW Health Clinical Policy 4.1.13, Hand
Hygiene.
5. Put on clean gloves. Using a tongue depressor, transfer a small amount (size
of a walnut for routine slides; size of an egg for qualitative studies, e.g.,
urobilinogen) of stool from clean bedpan/collection area to the appropriate
specimen container. Liquid stool may be poured into the transport container.
a. If there is visible foreign matter, blood and/or mucus in the stool,
include samples of these in the specimen.
b. Avoid contaminating the outside of the container.
6. Wrap tongue depressor in toilet tissue and discard in wastebasket.
7. Label according to Clinical Laboratories Policy 1502.5.06, Acceptance
Policy for Specimen Identification.
8. Secure requisition around specimen container with elastic band. Send
specimen to Core Laboratory.
9. Ambulatory locations:
a. For bacterial culture, transfer specimen to Para-Pak
®
C&S if unable to
transport to lab within 2 hours of collection time.
b. For other stool tests, refrigerate specimen in original container if
unable to transport to lab within 2 hours of collection.
B. Collection of Stool for Giardia/Cryptosporidium Antigen or Ova and Parasites Using
Para Pak O&P Kit.
1. Equipment
a. Para-Pak
®
O&P (PVA-Formalin) Kit, available from CS
b. Bedpan
c. Toilet tissue
d. Health Link order or Laboratory Requisition
e. Patient labels
f. Marking pen
g. Clean gloves
2. Collect stool in clean, dry, leak-proof container. Avoid contamination with
urine or water. Specimen to be collected from a clean area; i.e. diaper, hat,
bedpan or clean linen.
a. If specimen is collected in a bedpan have patient void in toilet or
another bedpan and use a second clean bedpan for collection of
specimen.
b. If patient is unable to defecate spontaneously, physician may order
suppository or saline enema. For specimens obtained by enema, only
saline cathartics are acceptable.
3. Perform hand hygiene according to UW Health Clinical Policy 4.1.13, Hand
Hygiene.

Page 3 of 3

4. Collect specimen wearing clean gloves.
a. Remove covers from specimen containers (vials). If any solution in
vials touches skin, flush with running water.
b. Using collection spoon built into lid of vial, transfer SMALL amounts
of stool into each vial until liquid rises to the "fill line." Liquid stool
may be poured into the transport container. It is important to sample
bloody, slimy or watery areas of specimen. If stool is formed (hard),
obtain sample from mid-portion. Avoid contaminating the outside of
the container.
c. Replace proper cover on each vial and twist firmly shut.
d. Label container according to Clinical Laboratories Policy 1502.5.06,
Acceptance Policy for Specimen Identification. Indicate time of
collection and other data as appropriate.
e. Shake each vial vigorously until fluid and stool are well mixed; return
vials to plastic bag.
f. Clean bedpan in established manner and return to designated area.
g. Send specimen to Laboratory
IV. UW HEALTH CROSS REFERENCES

A. Clinical Laboratories Test Directory (found on U-Connect)
B. Clinical Laboratories Policy 1595.P041, Fecal Occult (Guaiac) Hemoccult (Only
available in Lab)
C. Clinical Laboratories Policy 1502.5.06, Acceptance Policy for Specimen
Identification
D. UW Health Clinical Policy 4.1.13, Hand Hygiene

V. REFERENCES

A. Package insert - Hemoccult® (Available in Clinical Labs)
B. Package insert - OC-Light S FIT (Fecal Immunochemical Test), (Available in
Clinical Labs) Date of Issuance 2015-11-9.

VI. REVIEWED BY

Assistant Director, Clinical Laboratories
Clinical Nurse Specialist, Transplant Surgery
Clinical Nurse Specialist, Gynecology, Urology, Plastics & ENT, Inpatient Psychiatry
Department of Microbiology
Nursing Patient Care Policy and Procedure Committee, October 2017

SIGNED BY

Beth Houlahan, DNP, RN, CENP
Senior Vice President, Chief Nurse Executive