VRE Rectal Swab/Colostomy

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Ok, a resident in our LTC facility is diagnosed with VRE in the hospital. She has a colostomy. I take the order from the doctor, Bacitracin 10 days... reculture rectal swab x3...ect. I hang up from the doctor. Then it dawns on me.... rectal swab? she has a colostomy? I am a new nurse so wasn't sure about this... I ask my fellow vetran nurses and get all kinds of answers.... "hmmm, I'm not sure", "yes, you do a rectal swab, the bacteria is still carried in the rectum" "No, you swab the stoma, you have to test stool" What is the correct proceedure? I would have called the lab and asked but it was after hours. she does not have to be restested till after completion of anbx, but I want to know the correct answer!

Bea

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Ok, a resident in our LTC facility is diagnosed with VRE in the hospital. She has a colostomy. I take the order from the doctor, Bacitracin 10 days... reculture rectal swab x3...ect. I hang up from the doctor. Then it dawns on me.... rectal swab? she has a colostomy? I am a new nurse so wasn't sure about this... I ask my fellow vetran nurses and get all kinds of answers.... "hmmm, I'm not sure", "yes, you do a rectal swab, the bacteria is still carried in the rectum" "No, you swab the stoma, you have to test stool" What is the correct proceedure? I would have called the lab and asked but it was after hours. she does not have to be restested till after completion of anbx, but I want to know the correct answer!

Bea

I would have called the doc back for clarification. There is no shame in asking for it to be clarified.

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If the pt has a colostomy then the swab for vre should be from there. That's what I was told by our path lab when I asked them about the same thing!

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