Has anyone ever seen this done before?

[NCRN2010]

So last week I was assisting one of the providers at my employment and witnessed something I have never seen before. The patient we were caring for had a large leg wound. The provider wanted to culture the wound. So I prepared the patient and the room. The provider comes in and takes the swab of the culture and runs in under water from the faucet. She stated "I always get a better sample if the swab is wet first". Is this an accepted practice? Seems to me the culture swab would be contaminated from the tap water, and therefore the culture would not only be from the wound, but whatever else was lurking in the spigot, :sofahider and the city water.:barf02:Has anyone else witnessed this?

[tokmom, BSN, RN]

weird

[NCRN2010, BSN, RN]

ABSOLUTELY NOT....broke sterility. I agree with everyone else. I wonder what the Lab would say about that if they knew? or the Infectious Disease specialist (assuming that isn't who did this)....!!!!

What poor practice!

Was this guy out of the dark ages?

Actually, no the provider was a female ARNP. Had been a nurse for 15-20 years. Critical care, L&D, and med/surg. I was surprised at what she did. I expected more from her.

[NCRN2010, BSN, RN]

Are we assuming this patient dosen't take a bath/shower with the same water that was used to dampen the swab? Any bug in the water supply would be present on his skin and presumably in the wound. Pathogens that are capable of infecting a wound shouldn't be present in tap water. Any bug that cultures out would most likely be identified as normal flora- present on anyones skin(or perhaps in tap water), or pathogenic/infectious. I would expect the swab would be better off moistened with sterile water or saline, but I am more concerned that the chlorine in treated (city) tap water would inhibit the growth of any pathogens present in the wound.

I totally understand where you are coming from. Usually when you wash a wound, soap would be used as well, possibly eradicated any pathogens found in the tap water or spigot. Also, using ones own facilities is much different than water from a facility that has sick people in and out all day long, possibly contaminating the faucet. I'm not saying what she did was wrong or right, I have just never seen it done before. It would not be something I would have done.

Whats ironic to me is in the beginning days of my nursing career, I vividly remember being chastised for taking a culture swab out of the package and holding for the provider to use. The provider told me it was now contaminated just by exposing it to room air and made me discard the swab and get a new one...

[Susan317]

Also many may not know to not touch the swab part to only hold it by the plastic cap,otherwise you are culturing what is on your fingers.

[canchaser, BSN, RN]

There should be something at the bottom of the tube you can break to make it wet.

[diva rn, BSN, RN]

I totally understand where you are coming from. Usually when you wash a wound, soap would be used as well, possibly eradicated any pathogens found in the tap water or spigot. Also, using ones own facilities is much different than water from a facility that has sick people in and out all day long, possibly contaminating the faucet. I'm not saying what she did was wrong or right, I have just never seen it done before. It would not be something I would have done.

Whats ironic to me is in the beginning days of my nursing career, I vividly remember being chastised for taking a culture swab out of the package and holding for the provider to use. The provider told me it was now contaminated just by exposing it to room air and made me discard the swab and get a new one...

That's exactly what I was remembering and thinking of when I wrote that....also, there could not be enough chlorine added to the city water supply to eradicate all pathogens or the levels would render it too dangerous to drink...the point being that tap water is not sterile and would contaminate a culture immediately.