Gastrointestinal: Collecting a stool specimen (for nursing assistant training)

A stool specimen is a sample of the client's feces. It can be analyzed for the presence of blood mucous fat microbes such as bacteria and parasites or other abnormal findings.

Collecting a stool specimen can be helpful in diagnosing various conditions of the gastrointestinal system such as ulcers and cancer.

Before we discuss the procedure of collecting a stool specimen, here are some general considerations. Make sure to notify the client in advance at all times, respect the client's privacy and modesty by remembering to close the room's door, all window covers and ensuring the client is properly covered.

Ok. Now, when collecting a stool specimen first gather the supplies you'll need including gloves, paper towels, a specimen container, a collection device, toilet tissue, a tongue depressor and a biohazard transport bag.

You may also need a bedside commode, a bedpan or an occult blood test kit. Always double check the client's ID to make sure the procedure is performed on the right person.

Make sure that the specimen container is labeled with the client's name, room number as well as the correct date and time.

Put on gloves and cover the bathroom counter with a paper towel open the specimen container and place the lid on the paper towel with the inside facing up.

If the client can use a regular toilet, place a collection device at the back of the toilet bowl. For people who can't use the toilet, a bedside commode or a bedpan can be used.

It's important to remember that urine can alter the results. So ask the client to empty their bladder before collecting the stool.

If the client can't use the toilet, provide them with a voiding device. Give the client time to defecate and assist as necessary.

Remind them not to throw toilet tissue into the collection device. The bedside commode or the bedpan because this can alter the results.

For most clients, you can leave the room until they finish. Be sure that the call light is close to the client.

Remember to remove gloves when you leave dispose of them safely and put on a new pair when you come back. Don't forget to knock before entering, provide tissue paper, a moist cloth or pre moistened wipes if they are able to clean themselves.

Otherwise you should assist in the perineal care. Also assist the client with hand washing as necessary if the client didn't use the toilet, take the collection device or the bedpan to the bathroom.

Note the general quality, the amount, the color and the odor of the stool. Now to collect the stool specimen, you can use the spoon attached to the lid of the specimen container or a tongue depressor, take two tablespoons of feces and place them onto the specimen container.

If the stool is formed, the specimen should be taken from the middle of the stool. Also make sure to take a sample from areas with blood mucous or any areas that seem more watery.

If the stool is hard, take a sample from the middle and the two ends of the stool. If you use a tongue depressor, wrap it in paper towels or toilet tissue and dispose of it safely, close the specimen container tightly and place it back on the paper towel on the bathroom counter.

Now dispose of one glove and use the ungloved hand to hold the transport bag. Then with your gloved hand, put the specimen container into the bag, make sure not to touch the outside of the transport bag with the glove dispose of the other glove safely and wash your hands.

Now, sometimes the stool has to be warm when analyzed. So they have to be delivered to the laboratory right away.

Otherwise place them in the storage area until they're picked up. Now, you may be asked to test the stool for occult blood where occult means there's no visible evidence of bleeding.

This can be done using an occult blood test first, put on clean gloves, open the flap of the test slide, using a tongue depressor, take a small portion of stool and apply a thin smear on the test paper in the first box or box A of the slide.

Then using a different tongue depressor, take a stool specimen from a different part of the stool. Apply a thin smear on the second box or box B close a slight cover and turn it to the other side, open the cardboard flap and apply two drops of the developing solution that comes with a test kit on boxes A and B wait 10 to 60 seconds.

As specified by the manufacturer document, the color changes. A blue color indicates a positive test for occult blood in the stool, dispose of the test packet safely, wrap the tongue depressors and paper towels or toilet tissue and dispose of them.

Empty the rest of the stool into the toilet, wash your hands. Finally make sure to clean and return the equipment to the right place.

When collecting a stool specimen. There are some things you should report to the nurse right away.

Like if the client reports difficulty passing stool, excessive flatus or bloating fecal incontinence between bowel movements, any other change in their bowel habits like constipation or diarrhea or any abnormalities in the stool like blood or mucus.

These findings need to be documented after reporting also document the date and time you collected the stool specimen as well as the general quality, the amount and the color of the stool.

If a test for occult blood is done, document those results finally document if the specimen was transported to the laboratory right away or if it was stored until the scheduled pickup time.

All right. As a quick recap.

A stool specimen is a sample of a person's feces that can be analyzed for abnormal findings such as blood mucous fat and microbes.

To collect the stool specimen. You will need gloves, paper towels, a labeled specimen container, a collection device, toilet tissue, a tongue depressor, a biohazard transport bag and a fecal occult blood test kit.

If ordered for clients that can't use the toilet, you'll also need a bedside commode or a bedpan after the procedure. Make sure you report any unusual signs or symptoms to the nurse and leave proper documentation.