PATIENT CARE
Developed by:
Job Aid
Med Surg Nurse Educator
Formulated:
Revised: May 2011
Approved by CPC 5/06, 12/08, 5/11
Task/Process:
May 2006
Ref Policy #
Reviewed: December 2008
II-A-35
Page 1 of 2
Sputum Collection
FOR ALL PATIENT CARE PROCEDURES, BE SURE TO DO THE FOLLOWING:
As appropriate: Verify or secure order, verify informed consent, introduce yourself
and identify the patient per policy, explain procedure, wash your hands and use
appropriate PPE as required for the procedure.
A. Expectorate of Sputum Specimen
Equipment: Sterile Specimen cup with lid, biohazard bag for laboratory delivery, PPE
1. Follow Guidelines for Practice Prior to Treatment and Procedures (XVI-D-40).
2. Explain procedure to the patient
3. Verify correct procedure and correct patient using the patient’s hospital identification band (refer to HPP 8, use
name and account or medical record number).
4. Place patient in high fowler’s position unless contraindicated.
5. Don gloves and PPE as appropriate.
6. Have patient rinse mouth with water.
7. Tell patient to cough deeply and expectorate directly into the specimen cup (patient cannot simply clear throat and
expectorate saliva). Ensure lid remains sterile.
8. Place lid on specimen cup. Ensure exterior is clean.
9. Label with patient’s name, account or medical record number, date and time of collection and “Sputum” prior to
leaving the patient.
10. Place in biohazard bag and send to lab immediately.
11. Remove gloves, wash hands.
12. Record collection method used, date and time of collection, color and consistency of sputum, time sent to lab, and
patient tolerance.
B. Tracheal Suctioning
Equipment:
Sterile Suction Catheter Kit
Suction set-up
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PPE
Sterile in line specimen trap
Sterile gloves
Follow steps 1-3, Expectorate of Sputum Specimen.
Assess when patient last ate meal or had tube feeding and wait at least one hour after feeding.
Gather supplies and equipment.
Place patient in high-or semi-Fowler’s position for suctioning.
Verify suction machine and oxygen is set up and functioning properly.
Wash hands. Don sterile gloves, PPE.
Connect suction tubing to male adapter of the in-line trap and the suction catheter to the rubber tube on the in-line
trap.
Tilt patient’s head back slightly. Using sterile technique, lubricate the catheter with normal saline solution and
gently pass it through the patient’s nostril without suction.
When the catheter reaches the larynx, the patient will cough. Quickly advance the catheter into the trachea. Tell
him to take several deep breaths through his mouth.
To obtain the specimen, apply intermittent suction for 5 to 10 seconds, but never longer than 15 seconds. If
procedure must be repeated let patient rest first (do not perform more than two passes with the same catheter).
When collection is completed, discontinue the suction. Gently remove catheter.
Detach the catheter from the in-line trap. Gather up the catheter in your dominant hand and pull the glove cuff
inside out and down around the used catheter to enclose it for disposal. Remove and discard the other glove and
any PPE.
Detach the trap from the tubing connected to the suction machine. Seal the trap tightly by connecting the rubber
tubing to the male adapter of the trap. Examine the specimen to be sure it’s sputum, not saliva.
Label the trap’s container with patient’s name, room number, date and time collected and “Sputum” prior to leaving
the patient.
Place in biohazard bag and send specimen to the lab immediately.
15. Record collection method used, date and time of collection, color and consistency of sputum, time sent to lab, and
patient tolerance.
C. Tracheal Suctioning of Patient With Endotracheal Tube
Equipment: Sterile in line specimen trap
PPE
Suction set-up
Sterile gloves
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6.
Follow steps 1-3, Expectorate of Sputum Specimen.
Gather supplies and equipment.
Verify suction and oxygen are set up and functioning properly.
Place patient in high or semi-high Fowler’s position .
Wash hands. Don sterile gloves, PPE.
Connect suction tubing to male adapter of the in-line specimen trap and connect rubber tubing of in-line trap to inline suction catheter.
7. Advance the suction catheter without applying suction until a cough is obtained. Apply intermittent suction for 5 to
10 seconds, but never longer than 15 seconds. If procedure must be repeated, let patient rest first (do not perform
more than two passes with same catheter). When collection is completed, discontinue the suction. Gently remove
catheter.
8. Detach the specimen trap from the suction tubing and suction catheter and reconnect the suction tubing to the
suction catheter. Seal the trap tightly by connecting the rubber tubing to the male adapter of the trap. Examine
the specimen to be sure it’s sputum, not saliva.
9. Label the container with appropriate label with patient’s name, room number, date and time collected and
“Sputum” prior to leaving the patient.
10. Place in biohazard bag and send specimen to the lab immediately.
11. Record collection method used, date and time of collection, color and consistency of sputum, time sent to lab, and
patient tolerance.
Potential Complications:
 Patients with cardiac disease may develop arrhythmias during the procedure as a result of coughing, especially
when specimen is obtained by suctioning.
 Other complications may include: tracheal trauma or bleeding, vomiting, aspiration, and hypoxemia.
Special Considerations:
 Use sterile specimen container.
 Early morning specimen collection by deep coughing produces the best specimen.
 If sputum cultures are ordered “x 3”, collect one on each of 3 consecutive days.
 Determine the need for pre-oxygenation and provide prior to suctioning when appropriate and immediately replace
ordered oxygen after suctioning.
Reference: Berman, A., Snyder, S. Kozier, B. and Erb, B. Fundamentals of Nursing. Concepts, Process and Practice 8th ed.
Pearson: Prentice Hall, 2008