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Nasopharyngeal (NP Swab) Collection (102.014)

Nasopharyngeal (NP Swab) Collection (102.014) - Policies, Clinical, UWMF Clinical, UWMF-wide, Clinical Policies and Procedures, Clinical Procedure

102.014

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UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION
CLINICAL POLICY AND PROCEDURE

TITLE: NASOPHARYNGEAL (NP Swab) COLLECTION

Effective Date: April, 2004 Approval: See Authorization
Supersedes Protocol: None Contact: Clinical Staff Education

Reviewed April, 2005 April, 2009 September, 2009 August 2010 October 2010
November 2012 November 2013

PURPOSE: To provide guidelines for collecting a nasopharyngeal culture (NP swab) at University of
Wisconsin Medical Foundation (UWMF) or Department of Family Medicine (DFM) clinics.

DEFINITION: An NP swab may be needed for patients who present with signs or symptoms of an upper
respiratory infection. A NP specimen is often used to diagnose Influenza, Pertussis, or Respiratory syncytial
virus (RSV).

POLICY: The clinical staff will utilize the following guidelines to properly collect a nasopharyngeal culture on
a UWMF or DFM patient.
NOTE: During outbreaks of specific diseases, follow disease specific instructions available

SUPPLIES:
Flocked swab with appropriate transport media (M4 transport medium for viral testing)- 2 swabs are
recommended if testing for pertussis (Wisconsin Department of Health Services – see reference)
Regan-Lowe and PCR media for Pertussis testing, contact your lab for the correct media to use,
provider’s order,
patient’s record,
patient EPIC label,
gloves, gown, surgical mask,
eye protection (face shield or goggles), and
specimen biohazard bag

PROCEDURE:

1. Fill out lab requisition with:
Patient’s name; date and time of procedure; Name of test; and Source of specimen (if done manually)
Indicate requested test, Diagnosis, and if test is needed STAT (if done electronically)

2. Check provider’s order and clarify any inconsistencies.

3. Wash hands and gather equipment.

4. All providers/ staff must don the appropriate PPE prior to entering the exam room and keep on for duration of
time in the room.
Order for applying PPE :
1) Perform hand hygiene
2) Gown
3) Surgical mask
4) Eye protection (face shield or goggles)
5) Gloves

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5. Introduce yourself and identify the patient by asking the person to state their full name and date of birth.

6. Explain procedure to the patient while making patient comfortable by assisting patient to lie down or sit with head
tilted back. Inform patient that NP swab may be uncomfortable and cause eye tearing and coughing.

7. Provide good light and provide privacy by closing curtains or door.

8. Ask the patient if he or she has a deviated septum or nasal obstruction.

9. Ask the patient to blow their nose to remove any excess mucus from the
nasal cavity.

10. Insert flocked swab into nasal passage until slight resistance is met.
Note: 2 swabs are recommended if testing for pertussis. You may insert both swabs at the same time.
Note: Do not force the swab. If necessary, try the other nostril.

11. Gently rotate swab 10- 15 seconds in order to gather adequate epithelial cells from nasopharyngeal passage.




12. Place the swab in the appropriate transport media (M4 transport medium for viral testing, Regan-Lowe and PCR
media for Pertussis testing). ** Contact your lab for the correct media to use.

13. Cut/ break swab at pre-marked indentation.

*Ensure that the cap on the medium is on straight and tight.

14. Label Tube: place patient’s EPIC label on the tube; name of the test, the date and time of collection and the
collector’s initials. If an Epic label is not available, label the tube with the patient’s name, MRN and DOB,
indicate the time of collection and include your initials.

15. Consider repeating steps 10-14 again, if obtaining culture for pertussis.

16. Assist the patient to a comfortable position.

17. Discard other used materials immediately in proper container.

18. Place specimen tube into specimen biohazard bag

19. Remove PPE:
Remove gloves
Remove eye protection
Remove gown
Remove mask
Hand hygiene
NOTE: All disposable PPE may be discarded in regular trash, unless contaminated with blood or body fluids. If so,
discard in red biohazard trash.


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20. Close biohazard specimen bag properly and place lab requisition slip in outside pocket.

21. Take the specimen bag to lab or appropriate collection area.

22. Document in the patient’s record:
Education to patient regarding procedure
Name of test and source of specimen
Date and time of specimen collection
How the patient tolerated the procedure

WRITTEN BY: Ronnie Peterson, R.N., M.S., Manager of Clinical Support

REVISED BY: LaVay Morrison, RN, MSN, Clinical Staff Educator

REVIEWED BY: Don Dorn, UWMF Central Laboratory Manager
Laura Vergeront, RN, BSN, MPH, UWMF Employee Health/Infection Control Nurse

REFERENCES:

Association for Professionals in Infection Control and Epidemiology. (2013). Infection Prevention for Ambulatory
Surgery Centers: 2013 Infection Prevention Training Manual.

Centers for Disease Control and Prevention. (2011). Pertussis Testing Video: Collecting a Nasopharyngeal Swab Clinical
Specimen. Retrieved from: http://www.youtube.com/watch?v=zqX56LGItgQ

Wisconsin Department of Health Services. (2012). VPD Surveillance and Control Manual: Pertussis. Retrieved from:
http://www.dhs.wisconsin.gov/immunization/pdf/pertussis_guidelines.pdf

AUTHORIZED BY: Richard Welnick, MD, Medical Director, Ambulatory Clinic Operations, UWMF
Sandra A. Kamnetz M.D., Vice Chair, Department of Family Medicine


_______________________________________________________________________________
Medical Director, UWMF Date

________________________________________________________________________________
Vice Chair, Department of Family Medicine Date