19.9 Checklist for Obtaining a Nasal Swab

Use the checklist below to review the steps for completion of “Obtaining a Nasal Swab.”

Steps

Disclaimer: Always review and follow agency policy regarding this specific skill.

1. Gather supplies: N95 respirator (or face mask if respirators are not available), gloves, gown, eye protection (goggles or disposable face shields that cover the front and sides of the face), and physical barriers (e.g., plexiglass) if needed.
2. Apply appropriate PPE: gown, N95 respirator (or face mask if a respirator is not available), gloves, and eye protection are needed for staff collecting specimens or working within 6 feet of the person being tested.
3. Perform safety steps:
   • Perform hand hygiene.
   • Check the room for transmission-based precautions.
   • Introduce yourself, your role, the purpose of your visit, and an estimate of the time it will take.
   • Confirm patient ID using two patient identifiers (e.g., name and date of birth).
   • Explain the process to the patient and ask if they have any questions.
   • Be organized and systematic.
   • Use appropriate listening and questioning skills.
   • Listen and attend to patient cues.
   • Ensure the patient’s privacy and dignity.
   • Assess ABCs.
4. Open the sampling kit using clean technique on a clean surface. The kit should contain a biohazard bag, specimen container, and a nasal swab.
5. Remove the swab from the container being careful not to touch the soft end with your gloved hand or any other surface, which could contaminate the swab and either obscure the results or infect the patient.
6. Insert the swab into the nostril:
   • Anterior Nasal Swab: Have the patient tilt their head back at a 70-degree angle. Do not insert the swab more than a half an inch into the nostril.
   • Nasopharyngeal Swab: Insert until resistance is encountered or the distance is equivalent to that from the ear to the nostril of the patient, indicating contact with the nasopharynx.
7. Leave the swab in place as directed:
   • Anterior Nasal Swab: Leave in place for 10 to 15 seconds.
   • Nasopharyngeal Swab: Leave the swab in place for several seconds to absorb secretions.
8. Gently remove the swab:
   • Anterior Nasal Swab: Gently remove the swab after repeating Steps 6 & 7 in the other nostril.
   • Nasopharyngeal Swab: Slowly remove the swab while rotating it.
9. Place the swab in the sterile tube and snap the end off the swab at the break line. Place the cap on the tube.
10. Label the tube with the patient’s name, date of birth, medical record number, today’s date, your initials, time, and specimen type.
11. Place the specimen into the biohazard bag.
12. Remove the nonsterile gloves and place them in the appropriate receptacle.
13. Perform hand hygiene.
14. Assist the patient to a comfortable position, ask if they have any questions, and thank them for their time.
15. Ensure safety measures when leaving the room:
    • CALL LIGHT: Within reach
    • BED: Low and locked (in lowest position and brakes on)
    • SIDE RAILS: Secured
    • TABLE: Within reach
    • ROOM: Risk-free for falls (scan room and clear any obstacles)
16. Follow agency policy regarding transportation of the specimen to the lab. Report results appropriately when they are received.