Nursing & Healthcare Programs

Collecting a Stool Specimen

Written by Amanda R. McDaniel, MS, BSN, RN
Amanda is a BSN/RN with a MS in Physiology and a BA in English. She worked as a medical writer in the pharmaceutical industry for 11 years before pursuing a career in nursing. She now works as a nurse on a NeuroTelemetry unit and continues to write and edit on a freelance basis. Amanda’s LinkedIn

Stool specimens are collected to test for a variety of disorders from colon cancer to parasites. While it is not the most pleasant job, it is important that the collection is done correctly for accurate results.

How to Collect a Stool Specimen

  1. Gather the following supplies:
    • Gloves
    • Specimen pan (aka, hat) for the toilet or a bedpan
    • Specimen cup and lid
    • Appropriate label
    • Tongue blades
    • Biohazard bag
    • Toilet tissue or perineal care supplies
  2. Give the patient privacy by closing the door or curtain.
  3. Perform hand hygiene and don gloves.
  4. Ask the patient to urinate in the toilet or in the bedpan.
    • If in the bedpan, empty the urine into the toilet, and then clean and dry the bedpan.
    • If in the toilet, flush the urine, and then place the specimen pan toward the back of the toilet.
  5. Place the patient on the bedpan or help him onto the toilet. Give the patient time and privacy (while maintaining safety) to have a bowel movement. Return when the patient calls or signals that he is done.
    • If the patient is able to clean himself after the bowel movement, provide a trash receptacle for him to dispose of his toilet tissue. The tissue should not be placed in the specimen pan or bedpan with the stool.
  6. Assist the patient with perineal care and hand hygiene if necessary. Remember to discard the supplies in a container separate from the stool.
  7. Help the patient back to the bed.
  8. Note the amount and characteristics (color, consistency, smell) of the stool.
  9. If the stool is formed (has shape):
    • Use a tongue blade to scoop 2 tablespoons of stool into the specimen container, including any blood, mucus, or other discharge.
    • Take the sample from the center or from two different places per the order.
    • Wrap the tongue blade in toilet tissue and dispose appropriately.
  10. If the stool is unformed (liquid):
    • Carefully pour approximately 2 tablespoons of the stool into the specimen container.
  11. Place the lid on the specimen container and make sure the lid is tight.
  12. Change gloves.
  13. Place the patient’s name label on the container with the date, time, and initials of the collector per policy. This label may go on the outside of the biohazard bag, depending on institutional policy.
  14. Place the specimen container into a biohazard bag.
  15. Empty the remaining stool into the toilet and flush. Clean or dispose of the bedpan or specimen pan.
  16. Remove gloves and perform hand hygiene.
  17. Document the bowel movement per unit or institutional policy.
  18. Transport the specimen to the lab per institutional policy.

Reference

S. A. Sorrentino, & L. N. Remmert. (2012). Collecting and testing specimens. In Mosby’s textbook for nursing assistants (8th ed., pp 551-552). St. Louis, MO: Elsevier Mosby.

More Resources

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Applying Restraints

Restraints have very strict guidelines for use due to the number of complications that can result. Use of restraints is associated with increased physical and psychosocial health issues. Restraints are only considered necessary when restraint-free alternatives have failed and the patient or others are at risk of harm without the restraints. It is illegal to use restraints for the staff’s convenience or to punish the patient.

Perineal Care of the Male Resident

Perineal care should be performed during a bath, after using the bedpan, and/or after incontinence. Special care should be used when performing perineal care on an uncircumcised male. Failure to retract and wash the area under the foreskin can result in infection. Failure to return the foreskin to its normal position can result in paraphimosis.

Sim’s Position

The position a patient is placed in is often ordered by the physician, or recommended by a speech, occupational, or physical therapist. The position dictates whether a patient is sitting, lying, standing; or if they are on their side, back, or prone (face-down). Positioning is also determined by the patient’s current needs, such as: Are they eating? Sleeping? Having surgery on their back? Are they receiving nutrition through a nasogastric tube?

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A rectal temperature provides the most accurate core body temperature reading compared to other non-invasive methods. This makes a rectal temperature desirable; however, this procedure comes with more patient discomfort and more safety risks (bowel perforation, mucosal damage, and/or vagus nerve stimulation) than the other temperature measurement methods.

Indwelling Catheter Care

Indwelling catheters allow urine to drain from the bladder. They are used when residents are unable to urinate on their own or when the process of cleaning the resident after urination would be difficult for the resident to tolerate (such as during end of life care). Caring for the catheter appropriately is a vital part of preventing infection and skin breakdown.