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Not a Subscriber?CLINICAL DO'S & DON'TS RUSHING, JILL RN, MSN Jill Rushing is a nursing instructor at the University of Southern Mississippi in Hattiesburg. Richard L. Pullen, Jr., RN, EdD, coordinates
Clinical Do's & Don'ts, which illustrates key clinical points for a common nursing procedure. Because of space constraints, it's not comprehensive. doi: 10.1097/01.NURSE.0000261802.26909.5f  Nursing Quick LinksRelated Articles
By Cheryl Carver, LPN, WCC, CWCA, FACCWS, DAPWCA, CLTC I see it all of the time. Wound care clinicians performing wound cultures incorrectly, or obtaining cultures just because there is an open wound. With this being said, there are certain health care settings where per protocol, swab cultures are taken on every wound, even without signs and symptoms of infection. But I want you to always ask yourself a few questions when determining if a culture is warranted: Are there signs and symptoms of infection? Is there an odor after the wound has been cleansed? Has wound healing stalled? Maybe there is a biofilm present? Local Signs and Symptoms of Wound InfectionEvery wound has the potential for infection, but it is important to differentiate between infection and colonization. Wound care specialists have developed somewhat of a "trained eye", but there is no text edition that provides color photos of every wound with bioburden. Infection may be present if any of the following are present in the wound area:
Most Common Pathogens Found in Wounds
Types of Wound CulturesSwab culture: A swab culture is the most common technique used because it is non-invasive, and most cost-effective. This type of culture will usually identify the bacterial species of the infection, and help steer antibiotic therapy. Surface swabs will only unveil the colonizing organism, and may not reflect deeper tissue infection. An acceptable alternative to quantitative tissue culture is the Levine quantitative swab technique: The Levine Quantitative Swab Technique:
Deep-tissue biopsy: A deep-tissue or punch biopsy for a quantitative culture is the gold standard for identifying wound bioburden and diagnosing infection. Biopsies are invasive, painful, expensive, and not always available in all settings. Biopsies must be performed by qualified and trained providers, who aren’t always available. Needle culture: Needle aspiration is a less invasive technique to use in wounds such as puncture wounds. This method includes inserting a small 22 gauge needle. In order to obtain a sample of the fluid to be biopsied, the clinician pulls back on the plunger and then changes the angle of the needle two or three times to remove fluid from different areas of the wound. Careful assessment and documentation of the patient and the wound will help clinicians determine when to perform a wound culture for pathogens, and the best technique for gaining the culture sample. Protocol may vary depending on health care setting, so be sure to follow your facility guidelines. References: About the Author The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.
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Which action would the nurse take to obtain a wound specimen for culture?Which action would the nurse take to reduce the risk for wound infection when collecting a specimen for culture? Collect the specimen while wearing sterile gloves. Collect the specimen after washing the wound with sterile water. Collect the specimen before cleansing the wound.
Which technique is used to collect an aerobic culture specimen from a wound?In Brief. YOU MAY OBTAIN A CULTURE SPECIMEN from an infected wound to identify the causative organism and help determine the most effective therapy. Use appropriate technique, usually the Z-stroke swab culturing technique shown here.
When should a sputum specimen be collected quizlet?For best results, obtain the sample first thing in the morning. If you can't obtain the sample before the patient has breakfast, though, wait at least an hour after he's eaten before trying. Before you begin, describe the procedure to him. Ten to 15 ml of sputum is typically needed for laboratory analysis.
Why might the collection of a sputum specimen be delayed?Why might the collection of a sputum specimen be delayed up to 2 hours? The patient has just finished eating lunch. Which criterion makes it appropriate for the nurse to delegate to nursing assistive personnel (NAP) the skill of collecting a sputum specimen? The patient can produce the specimen by coughing.
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Which question might the nurse ask the patient when an aerobic wound culture has been ordered?
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