Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-09T15:23:37.875Z Has data issue: false hasContentIssue false
  • English
  • Français

Ordering Patterns, Collection, Transport, and Screening of Sputum Cultures in a Community Hospital: Evaluation of Methods to Improve Results

Published online by Cambridge University Press:  02 January 2015

Julie T. Jacobson ,
John P. Burke  and
Jay A. Jacobson
Julie T. Jacobson*
Affiliation:
Division of Infectious Disease, Department of Medicine, LDS Hospital, Salt Lake City, Utah University of Utah College of Medicine, Salt Lake City, Utah
John P. Burke
Affiliation:
Division of Infectious Disease, Department of Medicine, LDS Hospital, Salt Lake City, Utah University of Utah College of Medicine, Salt Lake City, Utah
Jay A. Jacobson
Affiliation:
Division of Infectious Disease, Department of Medicine, LDS Hospital, Salt Lake City, Utah University of Utah College of Medicine, Salt Lake City, Utah
*
Division of Infectious Diseases, LDS Hospital, 325 8th Ave., Salt Lake City, UT 84143
Get access Rights & Permissions [Opens in a new window]

Abstract

The clinical usefulness of sputum cultures depends on the quality of specimens submitted to the laboratory. In a community hospital, during two separate surveillance periods, we evaluated ordering practices and circumstances under which sputum specimens were obtained and techniques to improve the quality of the specimens. Physicians themselves rarely participated in obtaining specimens of sputum, and members of the nursing staff directly instructed patients or supervised specimen collection in only one third of cases. The mean elapsed time from collection at the bedside to processing in the laboratory was two hours, with a range from several minutes to 13 hours. One fifth of all the specimens in this study were obtained from patients with no discernible evidence of lower respiratory tract infection. Microscopic screening revealed that one half of the specimens were of poor or uncertain quality. After the first survey, inservice education of nursing personnel in the proper techniques of sputum collection, along with regular use of the screening procedure in the clinical laboratory, failed to effect any long-term change in ordering patterns or collection practices. However, the screening procedure did improve the quality of the sputum cultured, through rejection of unsatisfactory specimens [Infect Control 1981; 2(4):307-11.]

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 2 , Issue 4 , August 1981 , pp. 307 - 311
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1981

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Bartlett, RC. A plea for clinical relevance in medical microbiology. Am J Clin Pathol 1974;61:867–72.Google Scholar
2.Barrett-Connor, E. The nonvalue of sputum culture in the diagnosis of pneumococcal pneumonia. Am Rev Respir Dis 1971;103:845–8.Google Scholar
3.Geckler, RW, Gremillion, DH, McAllister, CK, Ellenbogen, C. Microscopic and bacteriological comparison of paired sputa and transtracheal aspirates. J Clin Microbiol 1977;6:396–9.CrossRefGoogle ScholarPubMed
4.Chodosh, S. Examination of sputum cells. N Engl J Med 1970;282:854–7.CrossRefGoogle ScholarPubMed
5.Epstein, RL. Constituents of sputum. A simple method. Ann Int Med 1972;77:259–65.CrossRefGoogle ScholarPubMed
6.Bartlett, RC. Medical Microbiology: Quality Cost and Clinical Relevance. New York, John Wiley & Sons, 1974:24–31.Google Scholar
7.Murray, PR, Washington, JA II. Microscopic and bacteriologie analysis of expectorated sputum. Mayo Clin Proc 1975;50:339–44.Google Scholar
8.Tilton, RC, Maderaza, E, Iannini, P, Quintijiani, R. The bacteriological examination of sputum. Ann Clin Lab Sci 1974;4:60–3.Google Scholar
9.Jefferson, H, Dalton, HP, Escobar, MR, Allison, MJ. Transportation delay and the microbiological quality of clinical specimens. Am J Clin Pathol 1975;64:689–93.Google Scholar
10.Thorsteinsson, SB, Musher, DM, Fagan, T. The diagnostic value of sputum culture in acute pneumonia. JAMA 1975;233:894–5.CrossRefGoogle ScholarPubMed
11.Williams, SG, Kauffman, CA. Survival of Streptococcus pneumoniae in sputum for patients with pneumonia. J Clin Microbiol 1978;7:3–5.Google Scholar
12.Monroe, PW, Muchmore, HG, Felton, FG, Pirtle, JK. Quantitation of microorganisms in sputum. Appl Microbiol 1969;18:214–20.CrossRefGoogle ScholarPubMed
13.Edwards, LD, Levin, S, Balagtas, R, Lowe, P, Landau, W, Lepper, MH. Ordering patterns and utilization of bacteriologie culture reports. Arch Intern Med 1973;132:678–82.Google Scholar
14.Porschen, RK. Experience with a microscopic screening program for sputum specimens. Health Lab Sci 1977;14:17–21.Google Scholar
15.Heineman, HS, Chawla, JK, Lofton, WM. Misinformation from sputum cultures without microscopic examination. J Clin Microbiol 1977;6:518–27.Google Scholar