STOOL SPECIMEN COLLECTION – GENERAL GUIDELINES

Collecting a stool specimen is a common diagnostic procedure used to analyze fecal matter for various reasons, such as detecting infections, parasites, or gastrointestinal disorders.

Here’s a general guide on collecting a stool specimen:

1. Gathering Materials:
   • Use a clean, dry container with a tight-fitting lid. Healthcare providers often provide specific containers for stool collection.
   • Consider using disposable gloves to maintain hygiene during the collection process.
2. Timing:
   • Collect the stool sample as soon as possible after it is produced to ensure the accuracy of the results.
3. Avoid Contamination:
   • Make sure the stool does not come into contact with urine or toilet bowl water.
   • Some healthcare providers may recommend using a plastic wrap or disposable plastic container placed in the toilet bowl to catch the stool.
4. Collection:
   • Using a clean plastic or wooden spatula, tongue depressor, or a similar device, collect a small amount of stool (about the size of a walnut) from different areas of the stool sample.
   • Place the sample into the container, ensuring that it is well-sealed to prevent leakage and contamination.
5. Labeling:
   • Label the container with your name, date of collection, and any other information required by your healthcare provider.
6. Transport to the Laboratory:
   • Deliver the stool specimen to the laboratory as soon as possible after collection. Some tests may require the sample to be delivered within a specific timeframe.
7. Storage:
   • If immediate delivery is not possible, store the specimen in the refrigerator until you can transport it to the laboratory.
8. Special Instructions:
   • Some tests may require additional instructions, such as collecting multiple samples over consecutive days or following a specific diet before collection. Follow any guidelines provided by your healthcare provider.
9. Preservation Solutions:
   • In some cases, the healthcare provider may provide a preservative solution to mix with the stool sample. Follow the instructions for using any provided solutions.
10. Documentation:
    • Document any relevant symptoms or information that may aid in the interpretation of the test results.

STOOL-ROUTINE TEST AND CULTURE

Collection of stool specimen for specific or routine tests (stool culture to detect abnormal characteristics)

Purpose

• To identify specific pathogens
• To determine presence of blood, ova and parasites
• To determine presence of fat
• To do gross examination of stool characteristics such as color, consistency and color

Normal Characteristics of Feces

• Color: light to dark brown
• Odor: pungent smell
• Frequency: 1-2 times per day
• Quantity: 4-5 ounces per day
• Composition: 30% water, shed epithelium from the intestine, a considerable quantity of bacteria and a small quantity of nitrogenous matter
• Stool of infants: at birth, the stool of infants is dark green and it is called “meconium”

Abnormal Characteristics of Feces

Color

• Tarry black stools – bleeding in the upper gastro-intestinal tract
• Black color stool – melena, administration of iron or charcoal
• Clay colored stool – obstruction to the flow of bile
• White colored stool – presence of barium salts after barium tests

Odor

Melana and dysentery – foul smell

Frequency

• Diarrhea – increased frequency
• Constipation – decreased in frequency and low residue diet

Consistency and Form

• Watery stools – diarrhea
• Rice water stools – cholera
• Pea soup stools – typical of typhoid fever

Appearance

• Fresh blood in large amounts – bleeding piles
• Blood and mucus stool – amoebic or bacillary dysentery
• Worm or segments or worms in stool – parasitic cysts, ova or larvae

General Instructions

• Fecal specimens are collected for chemical bacteriological or parasitological analysis
• Fecal specimens should be collected in the early stages of disease preferably before antibiotic treatment is given
• Stool specimens should be collected in a sterile container (making use of the scoop provided in the container) with a tight-fitting leak proof lid
• After collection, the lid should be immediately replaced tightly
• After proper labeling, the collected stool should be handed over to the laboratory without delay

Preliminary Assessment

Check

• The doctors order for any specific instructions
• General condition and diagnosis of the patient
• Assess the self-care ability
• Mental status to follow instructions
• Articles available in the unit

Preparation of the Patient and Environment

• Explain the procedure to the patient
• Provide privacy
• Arrange the articles at bedside
• Obtain laboratory request and container

Equipment

• Appropriate specimen container
• Spatula (clean for routine, sterile for culture)
• Bedpan or portable commode
• Gloves
• Waste paper

Procedure

• Instruct patient to defecate into clean dry bedpan or commode
• Instruct not to contaminate specimen with urine
• Nurse to wear gloves while collecting specimen
• Collect stool specimen with clean spatula for routine stool test and with sterile spatula into culture container
• Cover the container tightly

After Care

• Remove the gloves
• Wrap spatula in waste paper and discard appropriately
• Label specimen container with name, hospital number, and date
• Send to laboratory immediately (fresh specimen provides more accurate results)
• Replace equipment and after cleaning
• Record the procedure in nurse’s record sheet