Collecting sputum specimen

Sputum is the mucus secretion from the lungs, bronchi and trachea, but it is different from saliva. The best time for sputum specimen collection is in the mornings up on the patient’s awaking (that have been accumulated during the night). If the patient fails to cough out, the nurse can obtain sputum specimen by aspirating pharyngeal secretion using suction.

Purpose
Sputum specimen usually collected for:
• Culture and sensitivity test (i.e. to identify the microorganisms and sensitive drugs for it)
• Cytological examination
• Acid fast bacillus (AFB) tests
• Assess the effectiveness of the therapy

Equipments Required
• Disposable gloves
• Specimen container
• Laboratory requisition form
• Mouth care (wash) tray

Procedure
1. Patient preparation
• Before collecting sputum specimen, teach pt about the difference between sputum and saliva, how to cough deeply to raise sputum.
• Position the patient, usually sitting up position and splinting may help. Also postural drainage can be used.
• Give oral care, to avoid sputum contamination with microorganisms of the mouth. Avoid using tooth past because it alter the result.

2. Obtain sputum specimen
• Put on gloves, to avoid contact with sputum particularly it hemoptysis (blood in sputum) present.
• Ask pt to cough deeply to raise up sputum
• Take usually about 15-30 ml sputum
• Ask pt to spit out the sputum into the specimen container
• Make sure it doesn't contaminate the outer part of the container. If contaminated clean (wash) with disinfectant
• Cover the cape tightly on the container

3. Recomfort the patient
• Give oral care following sputum collection (To remove any unpleasant taste)

4. Care of the specimen and the equipments used
• Label the specimen container
• Arrange or send the specimen promptly and immediately to laboratory.
• Give proper care of equipments used

5. Document the amount, color, consistency of sputum, (thick, watery, tenacious) and presence of blood in the sputum.