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Nasopharyngeal Wash Specimen Collection (102.015)

Nasopharyngeal Wash Specimen Collection (102.015) - Policies, Clinical, UWMF Clinical, UWMF-wide, Clinical Policies and Procedures, Clinical Procedure




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

Reviewed April, 2005 August 2010 October 2012

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

DEFINITION: A nasopharyngeal wash specimen may be needed for patients who present with signs or symptoms of
an upper respiratory infection. A NP collection is often used to diagnose Influenza, Pertussis, or Respiratory Syncytial
Virus (RSV).

POLICY: The clinical staff will utilize the following guidelines to properly collect nasopharyngeal specimens
on UWMF or DFM patients.

**during outbreaks of specific diseases, follow disease specific instructions available

SUPPLIES: 3 ml syringe, 21 gauge butterfly IV catheter, needle to draw up solution,
Sterile 9% Sodium Chloride Solution (NaCl),
Viral transport media (get from lab prior to procedure), specimen biohazard bag, surgical mask,
gown, gloves, tissues, emesis basin, Provider’s order, Patient’s record, patient label

1. Fill out lab requisition (if done manually) with:

Patient’s name; date and time of procedure; name of test; and source of specimen
OR – if done electronically
Indicate requested test, diagnosis, and if test is needed STAT

2. Wash hands and gather equipment.

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

4. Draw up 3 ml of NaCl (sodium chloride) solution.

5. Cut the needle off a butterfly IV catheter.
Discard the distal (needle) end of this device in sharps container

6. Attach the tube portion of the butterfly to the syringe of NaCl.

7. 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 putting on PPE :
1. Perform hand hygiene
2. Gown
3. Surgical mask
4. Gloves
8. Introduce yourself and identify the patient by asking the person to state their full name and date of birth.

9. Explain procedure to the patient.
NOTE: Explain that there may be a slight discomfort or a gag during the procedure; assure patient that the
discomfort will stop after the procedure is completed.

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

11. Drape a clean sheet or chux over the patient’s chest.

12. Determine length of tubing (that should be advanced) by measuring the tubing from the tip of the patient’s
nose to the tip of the earlobe.

13. Tilt the patient’s head back approximately 70 degrees.
Instruct patient not to swallow during the procedure.
Instruct patient to cough – but DO NOT allow them to blow their nose.

14. Gently insert tubing into one nostril.

15. Inject the NaCl solution rapidly.

16. Immediately position the patient’s chin to chest allowing the injected solution to drip out of the nostril into
the Viral transport media.
Have emesis basin and tissue ready for patient to use.
You may be directed to administer this procedure to both nostrils.
Ensure that the cap on the medium is on straight and tight.

17. After removing tube, make patient comfortable.

18. Label Tube: place patient label on the tube; ndicate the time of collection and include your 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

19. Place specimen tube into specimen biohazard bag

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

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

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

23. 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., Clinical Staff Educator

REVISED BY: Carol Decker, RN, MSN, Clinical Staff Educatore

REVIEWED BY: LaVay Morrison, RN, BSN, Clinical Staff Educator
Don Dorn, UWMF Central Laboratory Manager
Jeanne Venzke, RN, BSN, MS, Employee Health Infection Control & Safety

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

Vice Chair, Department of Family Medicine