The student nurse verbalizes the procedure for obtaining a wound culture to the nurse preceptor. Which of the following statements by the student indicate a correct understanding? Select all that apply. A)"I will apply the prescribed bacitracin ointment after collecting the wound culture." B)"I will cleanse the wound by gently flushing it with normal saline." C)"I will obtain a sample of the drainage accumulated since the last dressing change." D)"I will perform hand hygiene and apply new gloves before obtaining the wound culture." E)"I will swab the wound from the outermost margin toward the center."

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11ecbb05_cb7f_2278_b433_af656ece3fa5_MD0009_00 Wound cultures identify microorganisms to aid in prescribing appropriate antibiotics and are obtained as follows: Perform hand hygiene, and apply clean gloves. Remove the old dressing. Remove and discard gloves. Perform hand hygiene, and apply sterile gloves. Assess the wound bed. Cleanse the wound bed and surrounding skin with normal saline (eg, flushing, swabbing with gauze) to remove drainage and debris (Option B). Remove and discard gloves. Perform hand hygiene, and apply clean gloves. Gently swab the wound bed with a sterile swab, from the wound center toward the outer margin (Options D and E). Avoid contact with skin at the wound edge as it can contaminate the specimen with skin flora. Place the swab in a sterile specimen container; avoid touching the swab to the outside of the container. Apply prescribed topical medication (eg, bacitracin) after obtaining cultures to prevent interference with microorganism identification (Option A). Apply new dressing. Remove and discard gloves, and perform hand hygiene. Label the specimen, and document the procedure. (Option C) Pooled purulent exudate likely contains skin flora different from the pathogen(s) responsible for the infection. Microorganisms responsible for infection are most likely found in viable tissue. Educational objective: Wound cultures are used to identify microorganisms and select appropriate antibiotics. The nurse should assess and clean the wound, swab from the wound center toward the outer margin, and avoid contamination (eg, hand hygiene, not touching intact skin with swab) to prevent misidentification of microorganisms.

The Student Nurse Verbalizes the Procedure for Obtaining a Wound