Collection of Sputum Samples (Nursing)

00:00 Hello. Today I'm going to walk you through the steps of collecting a sputum sample for analysis. We're going to use a patient scenario to help you see how these steps look in the clinical environment.

00:12 Now your patient, Mr. Smith, is an older adult client who came into the hospital through the emergency department.

00:19 Our provider suspects pneumonia, and his health care team orders a sputum sample for analysis to confirm the diagnosis and identify the cause of the pathogen. So let's start with step one.

00:30 Let's explain the procedure.

00:32 Now, before collecting the sample, you want your patient to understand why you are collecting their sputum.

00:39 We want to inform Mr. Smith that sputum collection is going to help identify that type of infection that's in his lungs.

00:47 You also want to emphasize the importance of producing a deep cough to avoid contamination with saliva, as that sample must come from the lungs.

00:57 It can be helpful to have the patient take several deep breaths before attempting to deep cough. Now, most guidelines are going to recommend having the patient perform oral care before collecting the sample, and at a minimum, the patient should at least rinse their mouth with water, although full teeth brushing is preferred.

01:18 Now we're ready to gather our supplies.

01:20 If you haven't already, you're going to need a sterile sputum collection container like you see here.

01:26 Some gloves. And really, a face mask is recommended for your protection. Now, you really don't know what might come up from your patient. Remember, though, that airborne particles can travel in a 4 to 6 foot radius. Now, once we have gathered all of our supplies, we can prepare the patient.

01:46 Ensure Mr. Smith is positioned upright, as this will help facilitate easier coughing. And if he can have them sit on the side of the bed.

01:54 Or even standing will help with lung expansion.

01:58 Now it's ideal to collect the sample as early in the morning when secretions are far more concentrated. Now let's move on to the coughing technique.

02:08 We want to instruct Mr.

02:09 Smith to take a deep breath and cough forcefully from his chest to produce the sputum. We want to ensure that that sample is expelled directly into the container, without touching the rim or the outside of the container.

02:24 Now, once we've obtained our sample, we need to assess its characteristics.

02:28 This is really important.

02:30 It should be thick mucus like, have a color to it.

02:34 Now this color could be green, yellow, white.

02:37 Now this indicates it's from the lungs.

02:40 Now if that sample appears thin or watery, it might be contaminated with saliva. And we need a new sample.

02:48 Now, as soon as we obtain that, we need to immediately seal the sputum container. And we've got to make sure to label it with Mr.

02:55 Smith's name, their date of birth, their medical record number, and the time of the collection.

03:01 We want to double-check that that label information is accurate to avoid sample mix-ups in the lab. Now, what if we are having a hard time producing sputum? You can try to reposition your patient or use chest physiotherapy or percussion to loosen secretions.

03:20 Now, in some cases, a nebulizer treatment with saline can also help generate a more productive cough. Now, if saliva contaminates the sample, review the coughing technique with Mr.

03:29 Smith and repeat the collection process.

03:32 Now instruct him to avoid swallowing.

03:34 Ensure a forceful cough that originates deep within the lungs.

03:38 Now you collected the sputum following evidence based guidelines and the causative agent of Mr. Smith, pneumonia gets diagnosed because we now know that bacteria is wreaking havoc in his lungs, targeted antibiotic therapy is now ordered.

03:52 With more specific treatment, Mr.

03:55 Smith begins to improve.

03:57 Yes, there are other care interventions involved, but accurate sputum collection is an important piece of his successful health care story. Now, by following these steps of accurate sputum sample collection, health care workers ensure that samples provide reliable information for laboratory analysis leading to effective clinical decisions.