welcome to ward 30 (neurology) - northumbria university · pdf filewelcome to ward 43 ... ward...

Student’s Name_______________________

Welcome to Ward 43

Neuromedicine

Neuroscience Directorate

Royal Victoria Infirmary

Added to Practice Placements, Northumbria University Website July 2012 2

This is your information pack please look after it

We hope that you find this helpful as you begin your placement on our ward.

The ward telephone number is 0191 282 6043

A useful website which outlines neurological conditions (without

overwhelming you with information) can be found at www.ninds.nih.gov.

The ward also has some patient information leaflets and text books that you

may find helpful, please ask your mentor about these.

Ward Checklist Try to get this completed shortly after you start your placement

Fire Safety Signature

of mentor

Shown location of fire extinguishers and fire panel

Action to be taken on hearing the fire alarm explained

Action to be taken on discovering a fire

Shown location on of assembly point

Evacuation procedure explained

Hand washing

Given hand washing techniques.

Observed correctly washing hands

Computers

Shown how to access the Intranet

Shown how to access policies and procedures

Multi-disciplinary team (where possible)

Opportunity to work with a qualified dietician.

Opportunity to work with OT.

Opportunity to work with physiotherapists.

http://www.ninds.nih.gov/


The Newcastle upon Tyne Hospitals NHS Foundation Trust

Ward 43 Royal Victoria Infirmary

Ward Profile

Ward 43 is a Neuromedical Ward comprising of 23 in patient beds and 6 day

case facilities. The ward is part of the Neuroscience Directorate.

The Senior Ward Sister is Eve Garside.

Ward 43 welcomes student nurses at all stages of their nurse training and aims

to provide an excellent and interesting learning environment.

A mentor will be allocated prior to you commencing your placement.

The shift times are:

Early 07.30 - 15.45

Late 12.30 - 20.30

Long Day 07.30 – 20.30

Night Duty 20.00 - 08.00

Ward 43 cares for a wide variety of patients; who have neurological

conditions such as Multiple Sclerosis, Parkinson’s Disease and Motor Neurone

Disease. Many patients will be given a new diagnosis which is potentially

debilitating and as such will require a great deal of emotional support. There

are other patients suffering from chronic conditions who are well known to the

ward staff and in some instances patients are admitted for terminal care.

There are many Consultants who work within the ward, all of whom have a

special area of neurological interest. The nursing staff work towards achieving

the ward philosophy and strive to offer a high standard of quality care to

patients with neurological conditions.

The nursing model used on Ward 43 (and across the Trust) is Essence of Care,

based around the original 9 elements (communication; continence, bowel

and bladder care; nutrition; pressure ulcers; personal and oral hygiene;

privacy and dignity; record keeping; safety and self care). Team nursing is

practiced on the ward and opportunities are provided to observe a number

of neurological investigations.

Ward 43 provides an excellent opportunity for students to appreciate the

effect a chronic illness can have upon a person and their carers and

therefore works closely with all members of the multi-disciplinary team.

Emergency telephone numbers are:

Cardiac Arrest 2222

Security 25704 (for routine enquiries)

Fire/Security 333 or 399 (for emergencies)

The resuscitation trolley is situated at the bottom of the main corridor.


Profile of Learning Opportunities


L

Ward 43

ITU Outreach

PEG Team

Social Worker

Chaplaincy

Epilepsy Nurse Specialist

Home Ventilation Team

MND Nurse Specialist

Tissue Viability

Nurse Consultant

Diabetic Team

Patient Services Co-ordinators

Dietician Physiotherapist

Neuro-Investigation Unit

MS Specialist Nurse

Speech and

Language Therapist

Continence Nurse

Consultant

Palliative Care Team

Occupational Therapist Link Nurses PD Nurse Specialist

District Hospitals

UNN

Social Services

Community Continence Advisors

MS Support Team Community Physiotherapist

Carers

GP’s

Community OT

District Nurses Macmillan Nurses

Hospices

Ambulance Service


INTERPERSONAL SKILLS

LEARNING OPPORTUNITIES

RESOURCE/ RELEVANT PERSONEL/

DEPARTMENT

Communication

Use of the telephone

Answering calls

Making calls

Ring back etc

Use of the computer

Understanding of confidentiality issues

Access to patient information

Patient investigation results

Use of Trust Intranet

Use of Internet

E mail access

Talking to

Patients

Relatives/Carers

Doctors

Visitors

Specialist Nurses

Multi disciplinary team

Members of the Multi disciplinary

Team

All Nursing Staff

Other Ward Staff

Other Hospitals

Organisation and Planning

Case Conference

Doctors Ward Rounds

Facilitating Investigations

Nurses handovers

Managerial Structure in Trust

Team working/team leader

Patient transfer in Trust

Patient transfer outside the Trust

Ward Clerk, Ward Staff

Ward Clerk, Ward Staff

Registered Nurse, Health Care

Assistant, Doctors, Multi disciplinary

Team, Specialist Nurses

Observation of roles

Domestic, Housekeeper

Registered Nurse, OT, Physiotherapist,

Social Worker, Specialist Nurses,

Doctors

Ward Manager, Sister

Observation of Roles

Patient, Relatives, Registered Nurse,

Patient Services Co-ordinator,

Receiving Ward Staff, Bed Manager,

Ambulance Service


CLINICAL SKILLS



DEPARTMENT

Patient hygiene

Bathing and Dressing

Mouth Care

Hair/Nail Care

Skin Care

Pressure care prevention

(Braden Scale)

Maintaining Privacy and Dignity

Promoting Independence

Recording of Physiological

Observations

Blood Pressure

Temperature, Pulse and Respirations

Weight

Oxygen Saturations

Blood Glucose

Forced Vital Capacity

Urine output

Maintaining Accurate Charts

Administration of Medication

Oral

Intramuscular

Subcutaneous

Rectal

Intravenous Drugs

Intravenous infusions

Miscellaneous

Cannulation/care of venflons

Medical Devices

Administration of blood and blood

products

Aseptic Non Touch Techniques

e.g. dressings

Risk Assessment

Body Mass Index

Use of aids/hoists

Infection control

Isolation of patients/Barrier Nursing

Catheter insertion and care

Management of incontinence

Urinalysis

CVP lines

Patient safety/falls.

Checking equipment

Tracheostomy Care

Staff Nurse, Health Care Assistant

Registered Nurse, Health Care

Assistant, Doctor,

Diabetic Specialist Nurse

Registered Nurse, Doctor, Pharmacist

Sister, Registered Nurse, Doctor

Registered Nurse, Home Ventilation


Non Invasive Ventilation

Insertion and care of PEG feeding

Tube

NG Tube management and feeding

Infection Control

Preparation for Investigations

Consent (informed)

Information – both verbal and written

Invasive radiology

Non-invasive radiology

Team,

PEG Team, Dietician

Sister, Registered Nurse,

Infection Control Team

HEALTH DEVELOPMENT OPPORTUNITIES


RESOURCE/ RELEVEANT PERSONEL/

DEPARTMENT

Healthy life style strategies in relation

to

Smoking cessation

Obesity

Diabetes

Health education and health

promotion literature

Sister, Registered Nurse, Doctor,

Smoking Cessation Service

Dietician

Diabetes Nurse Specialist

Ward Resources, Specialist Nurses

MANAGEMENT OF CARE




DEPARTMENT

Nursing process

Assessment

Use of Trust Documentation

Use of Nursing Model

Philosophy of Care

Relevance of Information

Collection of Information

Observation

Practice

Risk Assessment Tools

Planning Care

Care plans

Core Care Plans

Evaluation of Care

Discharge planning

Multi-disciplinary plan/working

OT

Physiotherapist

Social Worker

District Nurse

Discharge liaison

Specialist nurses

Relevant departments

Implementation / Evaluation

Ward rounds

Multi-disiplinary Team

Patient and Carer Involvement

Documentation

Standards

Protocols, Policies

Communication/ relatives/patient

Time management

Planning priorities

Dealing with difficult situations

Deceased patients

Patient property/Valuables

Self discharge

Religious Needs

Registered Nurse

Medical Notes

Patients, Carers

Community Staff

Registered Nurse, Social Worker, OT,

Physiotherapist, Doctors, Patient,

Carers

Registered Nurse, Social Worker OT,

Physiotherapist, Doctors, Patient,

Carers

Royal Marsden Handbook, Hospital

Intranet Policies and Procedures

Hospital chaplaincy


ORGANISATIONAL AND MANAGERIAL ISSUES


RESOURCE/ RELEVANT PERSONAL/

DEPARTMENT

Organisational Skills

Delegation

Role of the Ward Co-ordinator

Role of the Team leader

Standards of care

Quality Issues

Off duty

Time management

Managing patient work load

Management of Ward/Resources

Stock control

Ordering Drugs

Ward Sisters Responsibilities

Materials management

Managing Risk

Policies and Procedures

Equipment safety checks

Quality control

Weekly environment checks

Infection Control

Moving and Handling

Emergency Situations

Cardiac arrest

Violent Incidents, Security

Fire

Bed alerts

Patient falls

Staff Development

Clinical supervision

Reflective practice

Sister, Registered Nurse


Trust Intranet





NEUROLOGICAL DISORDERS



DEPARTMENT

Knowledge Nursing care of Patients

with :

Multiple Sclerosis

Parkinson’s Disease

Motor Neurone Disease

Chronic and Acute Neuropathy

Guillan Barre Syndrome

Epilepsy

Encephalitis

Creutzfeid Jakob Disease

Meningitis

Mysthenia Gravis

Headaches

Mitocondrial Disorders

Observation and Assistance with: (if

applicable)

Magnetic Resonance Imaging (MRI)

Computerised Axial Tomography (CT)

Electroencephalograph (EEG)

Electromyography (EMG’s)

Evoked Potentials (EP’s)

Visual Evoked Responses (VEP’s)

Muscle Biposy

Neuropsychometery

Addenbrookes Assessment

Neurological Observations

Patient Information Leaflets, Text

Books, Internet (www.ninds.gov.uk)

Sister, Registered Nurse, Doctor,

Specialist Nurses

Radiology

Neurophysiology

Theatre

Doctor

Registered Nurse

http://www.ninds.gov.uk/


Learning Opportunities within the MDT

S/N J Kane

Name Date

Neuro Theatre

– spinal surgery

– brain surgery

– intubation/anaesthetics

Neuro x-ray

- angiogram

- MRI

Neurophysiology

- EMG

- EEG

Physiotherapist

Dietitian

Occupational Therapist

Speech Therapist

Outreach Team

Pain Team

Palliative Care Team

Parkinsons Disease Specialist Nurse

MS Specialist Nurse

MND Specialist Nurse

Epilepsy Specialist Nurse

Head Injury Specialist Nurse

Neuro Oncology Specialist Nurse


Ward Philosophy

Ward 43 RVI

Our ward aim is to provide the best possible quality of care and support for

our patients, relatives and carers to help them to reach their full potential in

spite of any disability.

We also aim for our nursing staff to achieve job satisfaction and have the

opportunity to work within the Multi-Disciplinary Team in reaching our ultimate

goal of providing high quality, evidence based practice in looking after our

patients.

Ward 43 is recognised as being a Practice Development Unit, promoting a

pro-active environment, delivering high standards of holistic care where

everyone’s opinions are valued and respected.

Finally our staff endeavours to provide a friendly and professional atmosphere

in which patients and visitors will feel able to approach staff with any queries

and concerns. Maintaining good relationships between staff, patients and

visitors is essential in meeting our ultimate goal of providing the best quality of

care for patients.


List of Agreed Abbreviations

(taken from The Newcastle upon Tyne Hospitals NHS Foundation Trust

Clinical Record Keeping Policy November 2010)

Common Medical Conditions

AIDS Acquired Immunodeficiency Syndrome

Ca Cancer

CCF Congestive Cardiac Failure

COAD Chronic Obstructive Airways Disease

DVT Deep Vein Thrombosis

MI Myocardial Infarction

MRSA Methicillin Resistant Staphylococcus Aureus

PE Pulmonary Embolus

STAPH Staphylococcus

TB Tuberculosis

UTI Urinary Tract Infection

# Fracture

Patient Investigation (Radiology)

AxR Abdominal X-Ray

Ba Barium

CT SCAN Computerised Tomography

CXR Chest X-Ray

MRI Magnetic Resonance Imaging

U/S Ultrasound

Common Tests/Procedures

CPR Cardio Pulmonary Resuscitation

PEG Percutaneous Endoscopic Gastroscopy

TENS Trans Cutaneous Electro Nerve Stimulation

TPN Total Parenteral Nutrition

TPR Temperature Pulse Respiration

Medication/Drugs

IM Intra Muscular

Inh Inhaler

IV Intravenous

Neb Nebulisation

Oral

PO By Mouth

PR Per Rectum

PV Per Vagina

SC Sub Cutaneous

S/L Sub Lingual

Top Topical

CD Controlled Drug

IVI Intravenous Infusion

TTO To Take Home (Drugs)


Administration

Appt Appointment

ASAP As Soon As Possible

DNA Did Not Attend

DOB Date Of Birth

FU Follow Up

S/A Same Address

S/B Seen By

TCI To Come In

Equipment

ET Tube Endotracheal Tube

NGT Naso Gastric Tube

TED Thrombo Embolic Deterrents

People

CPN Community Psychiatric Nurse

Dr Doctor

F (1 or 2) Foundation trainee (year 1 or 2)

GP General Practitioner

HV Health Visitor

ST(n) Specialist Trainee (n= year of training)

SALT Speech And Language Therapist

SR Sister

S/N Staff Nurse

ST/N Student Nurse

Specialty

ENT Ear Nose and Throat

GI Gastro Intestinal

GYNAE Gynaecology

HDU High Dependency Unit

OPD Out Patients Department

OT Occupational Therapy

PAEDS Paediatrics

Patient Investigation (Blood)

FBC Full Blood Count

FFP Fresh Frozen Plasma

HB Haemoglobin

K Potassium

Na Sodium

PCV Packed Cell Volume

U/E Urea and Electrolytes

WCC White Cell Count


Patient Assessment/ Examination

BMI Body Mass Index

BP Blood Pressure

CNS Central Nervous System

CVP Central Venous Pressure

H/O History of

Ht Height

ICP Intracranial Pressure

NAD No Abnormality Detected

NBI No Bony Injuries

NOK Next Of Kin

PMH Past Medical History

SOB Shortness Of Breath

TPR Temperature Pulse Respirations

Wt Weight

Patient Investigation (General)

C&S Culture And Sensitivity

CSF Cerebro-Spinal Fluid

ECG Electro Cardiogram

LP Lumbar Puncture

MC&S Microscopy Culture And Sensitivity

MSU Mid Stream Urine

Other

LA Local Anaesthetic

GA General Anaesthetic

NBM Nil By Mouth

POST OP After Operation

PRE OP Before Operation

RTA Road Traffic Accident

ROS Removal Of Sutures


Neuroscience Abbreviations

(That you may see in documentation)

Medical/Surgical Conditions

A.C.D.F. Anterior Cervical Discectomy and Fusion

A.V.M. Arterio-Venous Malformation

C.V.A. Cerebro-Vascular Accident

E.D.H. Extra-Dural Haematoma

G.B.M. Glioblastoma Multiforma

I.C.H. Intra-Cerebral Haematoma

S.A.H. Subarachnoid Haemorrhage

S.D.H Sub-dural Haematoma

S.O.L. Space Occupying Lesion

T.I.A. Transient Ischaemic Attack

C.I.D.P. Chronic Inflammatory Demylinating Polyneuropathy

M.N.D. Motor Neurone Disease

M.S. Multiple Sclerosis

Procedures and Investigations

C.V.P Central Venous Pressure

E.E.G. Electro-encephlogram

E.M.G. Electro-myography

E.V.D. External Ventricular Drain

G.C.S Glasgow Coma Scale

I.C.P. Inter-cranial Pressure

L.P. shunt Lumbar-peritoneal Shunt

M.A.P. Mean Arterial Pressure

P.E.A.R.L Pupils equal and reacting to light

RESPS Respirations

V.P. shunt Ventriculo-peritoneal shunt

Bx Biposy

E.P. Evoked Potentials

I.V.I.G. Intra-venous Immunoglobulin

M.D.T. Multi-disiplinary Team


Investigations

C.T. Scan (Computerised Tomography)

This scan is carried out using x-rays alone (although an IV injection of a

contrast medium may often be used to clarify even further the pictures

obtained. X-rays are shone through the skull (or spinal column) on a series of

different planes and a computer analyses the results and produces

extraordinarily clear pictures of the skull, brain tissues, ventricles, subarachnoid

space and any abnormalities present in a very short period of time and with

no discomfort to the patient other than having to lie still.

M.R.I (Magnetic Resonance Imaging)

Even for C.T. scanning however there are some areas of the brain (posterior

fossa) which are difficult to illustrate. By exposing the patient’s head to a

powerful, but entirely safe, magnetic field, computers can again reproduce

an image of the skull, brain, CSF pathways and any lesions present in a very

clear picture and on different planes – i.e. as if looking at the brain from the

side. Some lesions show up by this method, which do not clearly show on C.T.

scanning and this applies particularly to the plaques of Multiple Sclerosis. It

can also be applied to muscular disease.

E.E.G. (Electro-encephlogram)

The living brain is constantly discharging small electrical waves, which can be

picked up from the surface of the head, magnified and recorded on paper.

The machine which does this is called an elecroencephalograph, and the

tracing it produces is called an electroencephalogram. Little electrodes are

held onto the scalp and spaced out over the whole skull. These are

connected to the recording pens and the controls of the machine allow

tracings to be made on the moving paper from a combination of these

electrodes.

E.M.G (Electro-myography)

The E.M.G. records electrical discharges given off in muscle fibres. Normally

there are none at rest but they become profuse when the muscle contracts.

Fine electrodes are either attached to the skin or introduced into the muscle

itself and the waves are seen on a little television screen and at the same

time photographed on the moving film so that they can be studied later. By

different wave patterns the E.M.G. helps to distinguish between the muscle

that is weak and wasted because its nerve supply is damaged, i.e. it is

denervated, and one whose disease is in the muscle itself, e.g. Muscular

Dystrophy. It can also be used to measure the speed with which an electrical

stimulus travels from some point on the nerve to the muscle that that nerve

supplies. It is called the nerve conduction time and the nerve conduction

velocity can also be measured. These may be delayed by nerve damage to

the nerve along its course.


L.P. (Lumbar Puncture)

Some neurological diseases produce clear-cut changes in the C.S.F. of great

value in diagnosis. In many others unfortunately the changes are too vague

to be helpful. The fluid can be obtained by L.P. Because the meninges run

further down the vertebral canal than does the cord itself, a sac containing

C.S.F. is formed in the lumbar region into which a needle can be passed and

fluid withdrawn, or substances injected, without damaging the cord.

Normally the patient is positioned to lie on one side, with the back right at the

edge of the bed and not leaning forwards. In order to separate the vertebral

spines, the head and neck are flexed and the knees are brought upwards

towards the chin. Heavy blood staining occurs if blood was already in the

C.S.F. (e.g. in Sub-arachnoid Haemorrage, or if a large vessel beyond the

theca is entered. C.S.F. pressure is measured by connecting a manometer to

the needle. The C.S.F. rises normally to a pressure of 100-150mm (of C.S.F.).

L/P. should not be performed if intracranial pressure is suspected.

E.P. (Evoked Potentials)

Using an electrode on the scalp the time taken for visual, auditory and

sensory stimulus to produce discharge in the brain. This is measured and if

delayed compared to normal this may mean a lesion in the pathways under

examination. For instance, if a patient’s only complaint is dragging the left

foot one may suspect Multiple Sclerosis. The demonstration of Visual Evoked

Potentials of a lesion in the left optic nerve would be evidence of more than

one lesion in the nervous system.

Read the definitions below, then label the brain anatomy diagram.


Cerebellum - the part of the brain below

the back of the cerebrum. It regulates

balance, posture, movement, and muscle

coordination.

Corpus Callosum - a large bundle of

nerve fibers that connect the left and

right cerebral hemispheres. In the lateral

section, it looks a bit like a "C" on its

side.

Frontal Lobe of the Cerebrum - the

top, front regions of each of the cerebral

hemispheres. They are used for

reasoning, emotions, judgment, and

voluntary movement.

Medulla Oblongata - the lowest section

of the brainstem (at the top end of the

spinal cord); it controls automatic

functions including heartbeat, breathing,

etc.

Occipital Lobe of the Cerebrum - the

region at the back of each cerebral

hemisphere that contains the centers of

vision and reading ability (located at the

back of the head).

Parietal Lobe of the Cerebrum - the

middle lobe of each cerebral hemisphere

between the frontal and occipital lobes; it

contains important sensory centers (located

at the upper rear of the head).

Pituitary Gland - a gland attached to the

base of the brain (located between the Pons

and the Corpus Callosum) that secretes

hormones.

Pons - the part of the brainstem that joins

the hemispheres of the cerebellum and

connects the cerebrum with the cerebellum.

It is located just above the Medulla

Oblongata.

Spinal Cord - a thick bundle of nerve

fibers that runs from the base of the brain to

the hip area, running through the spine

(vertebrae).

Temporal Lobe of the Cerebrum - the

region at the lower side of each cerebral

hemisphere; contains centers of hearing and

memory (located at the sides of the head).

Answers


Cerebellum - the part of the brain below

the back of the cerebrum. It regulates

balance, posture, movement, and muscle

coordination.

Corpus Callosum - a large bundle of

nerve fibers that connect the left and

right cerebral hemispheres. In the lateral

section, it looks a bit like a "C" on its

side.

Frontal Lobe of the Cerebrum - the

top, front regions of each of the cerebral

hemispheres. They are used for

reasoning, emotions, judgment, and

voluntary movement.

Medulla Oblongata - the lowest section

of the brainstem (at the top end of the

spinal cord); it controls automatic

functions including heartbeat, breathing,

etc.

Occipital Lobe of the Cerebrum - the

region at the back of each cerebral

hemisphere that contains the centers of

vision and reading ability (located at the

back of the head).

Parietal Lobe of the Cerebrum - the

middle lobe of each cerebral hemisphere

between the frontal and occipital lobes; it

contains important sensory centers (located

at the upper rear of the head).

Pituitary Gland - a gland attached to the

base of the brain (located between the Pons

and the Corpus Callosum) that secretes

hormones.

Pons - the part of the brainstem that joins

the hemispheres of the cerebellum and

connects the cerebrum with the cerebellum.

It is located just above the Medulla

Oblongata.

Spinal Cord - a thick bundle of nerve

fibers that runs from the base of the brain to

the hip area, running through the spine

(vertebrae).

Temporal Lobe of the Cerebrum - the

region at the lower side of each cerebral

hemisphere; contains centers of hearing and

memory (located at the sides of the head).


-30 sec 40-60

Staff Guidance for MRSA Patient Screening All patients who are to receive treatment from the Newcastle upon Tyne NHS Foundation Trust are screened for MRSA. This is a simple process involving swabs being taken from the nose, throat and perineum of all patients. Patients who have wounds and/or urinary catheters must have further relevant specimens taken. A full explanation must be given in all cases prior to commencement of the procedure. Privacy and dignity must be maintained at all time. All swabs must be labelled prior to use with the patient’s name, DOB, hospital number, ward and hospital. All accompanying documentation must have the aforementioned data as well as the named Consultant and clinical condition so that the laboratory is able to process the samples correctly. Specimens for screening must be labelled MRSA screen (If infection is a concern then request culture and sensitivity on the form as well). How to take the swabs Nose

Wash hands

Open the swab. Remove the container and twist off the plastic end.

Remove the swab without touching the cotton bud.

Place the cotton bud into one nostril and then the other touching the skin all around the inside of the resident’s nose.

Place the swab back into its container.

Throat

Wash hands



Ask the patient to open their mouth wide and gently touch the back of their throat with the cotton bud until they gag.

Place the swab back into its container. * In paediatrics consider the age and feasibility of achieving a throat swab. Do not take unless achievable.

Remember to swab both

nostrils

Remember to swab the back of the throat


Perineum *The perineum is the area of skin just in front of your anus or back passage. Allow the patient if able to complete this swab themselves. In paediatrics if inappropriate do not take perineum swab.

Wash hands



Touch the perineum with the cotton bud.


Wash hands. Wounds

Wash hands.

Put on disposable gloves and apron.

Remove the dressing and clean/irrigate the wound with normal saline as per local protocol and Trust aseptic technique (This will include de gloving at appropriate time, washing hands and donning new gloves.



Touch the clean part of the wound and swab towards the dirty with the cotton bud in a zig-zag motion.


Complete wound re dressing as per local protocol and Trust aseptic technique.

Wash hands. Collection of a catheter specimen of urine

Wash hands.

Put on disposable gloves and apron.

Clean the access point with 70% isopropyl alcohol impregnated swab and allow to dry thoroughly.

Do not break the closed system. Using a needless sampling port and following an aseptic technique insert the syringe firmly into the centre of the sampling port (following manufacturer’s instructions). Aspirate the required amount of urine and disconnect the syringe.

Clean access point with a swab saturated with 70% isopropyl alcohol.

Place the specimen in a sterile container.

Remove apron and gloves and wash hands. Record all information on swabs/specimens taken in appropriate documentation.

Gill Lishman March 2009

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