Training Manual: PCR Wound Sample Collection for Mobile Healthcare Providers

Table of Contents

1. Introduction
2. Understanding PCR Testing for Wound Infections
3. Pre-Sample Collection Preparation
4. Proper PCR Wound Sample Collection Techniques
5. Sample Handling, Transport, and Documentation
6. Troubleshooting and Common Errors
7. Practical Assessment and Certification
8. Appendices (Checklists, FAQs, References)

1. Introduction

Purpose of this Manual

This manual provides a step-by-step guide for nurses and medical assistants conducting PCR wound sample collection in skilled nursing facilities (SNFs) and assisted living facilities (ALFs). Proper sample collection is essential for accurate laboratory results, which inform appropriate clinical treatment.

Learning Objectives

After completing this training, participants will be able to:

• Understand the importance of PCR molecular testing for wound infections.
• Identify the necessary equipment and follow aseptic sampling techniques.
• Perform proper sample collection to minimize contamination.
• Handle, label, and transport samples according to best practices and regulations.
• Troubleshoot common errors in sample collection.

2. Understanding PCR Testing for Wound Infections

What is PCR Testing?

Polymerase Chain Reaction (PCR) testing is a molecular diagnostic method that detects DNA or RNA of pathogens in a wound sample. Unlike traditional culture methods, PCR testing can:

• Identify multiple pathogens quickly and accurately.
• Detect antibiotic resistance genes.
• Provide quantitative data for infection severity.

Why Use PCR Testing for Wound Infections?

• Faster diagnosis compared to traditional culture (results within 24 hours vs. 3-5 days).
• More accurate pathogen identification (including difficult-to-culture bacteria and fungi).
• Prevention of unnecessary antibiotic use, reducing antibiotic resistance.
• Improved patient outcomes in long-term care settings.

3. Pre-Sample Collection Preparation

Required Materials

• PCR swab collection kit
• Sterile gloves and PPE (mask, gown, eye protection)
• Sterile saline (if applicable)
• Biohazard bag
• Requisition form and labels

Infection Control & Aseptic Techniques

• Perform hand hygiene before and after the procedure.
• Wear sterile gloves and avoid touching non-sterile surfaces.
• Use aseptic technique to prevent contamination.
• Ensure the sample is collected from the wound bed, not exudate or necrotic tissue.

4. Proper PCR Wound Sample Collection Techniques

Step-by-Step Collection Process

1. Verify patient identity and document wound location.
2. Cleanse wound area with sterile saline (if necessary) to remove debris.
3. Select an appropriate flocked swab for sample collection.
4. Use the Levine or Z-Stroke technique:
   
   • Levine Technique: Press swab into the wound with gentle pressure and rotate in a 1 cm² area.
   • Z-Stroke Technique: Move swab in a zigzag motion across the wound bed.
5. Immediately place the swab into the transport tube, ensuring a secure seal.
6. Properly label the specimen with patient details, date, time, and collector’s initials.
7. Dispose of used PPE and waste according to biohazard protocols.

5. Sample Handling, Transport, and Documentation

Proper Labeling

Each sample must include:

• Patient name and ID number
• Date and time of collection
• Site of wound
• Collector’s initials

Sample Transport Guidelines

• Keep sample at recommended temperature (refrigerated if required).
• Use designated biohazard transport bags.
• Ensure timely courier pick-up and delivery to the laboratory.

Regulatory Compliance

• Follow CLIA and CAP standards for specimen collection.
• Complete necessary electronic medical record (EMR) entries.

6. Troubleshooting and Common Errors

Common Collection Mistakes

• Dry swab or insufficient sample → Ensure proper contact with the wound bed.
• Touching surrounding skin or pus → Avoid contaminating the sample.
• Incorrect labeling or incomplete requisition forms → Double-check patient details.
• Delayed transport → Ensure samples reach the lab within the required timeframe.

How to Prevent Inconclusive Results

• Always follow standardized collection procedures.
• Do not collect from necrotic tissue or heavily contaminated areas.
• Store and transport samples correctly to maintain integrity.

7. Practical Assessment and Certification

Hands-on Practice Requirements

Participants must:

• Demonstrate proper sample collection techniques.
• Correctly label and document sample information.
• Pass a 10-question competency assessment.

Certification

Upon successful completion, participants receive a Certificate of Competency in PCR Wound Sample Collection.

8. Appendices

Appendix A: PCR Wound Sample Collection Checklist

✅ Verify patient identity and wound site
✅ Perform hand hygiene and wear PPE
✅ Use correct collection technique (Levine or Z-Stroke)
✅ Place swab in transport tube and seal properly
✅ Label sample accurately
✅ Complete documentation and requisition form
✅ Store and transport sample correctly

Appendix B: Frequently Asked Questions (FAQs)

Q: Can a PCR sample be collected from a dry wound?
A: No, a small amount of sterile saline can be used to moisten the wound bed before swabbing.

Q: What should I do if I accidentally touch the skin while collecting the sample?
A: Discard the swab and use a new one to avoid contamination.

Q: How soon should the sample reach the lab?
A: Ideally within 24 hours; follow your laboratory’s specific guidelines.

Appendix C: References

1. Clinical Laboratory Standards Institute (CLSI) Guidelines on PCR Sample Collection
2. Centers for Disease Control and Prevention (CDC) Guidelines on Infection Control
3. CAP Standards for Molecular Diagnostics

End of Training Manual

This manual serves as a complete guide to PCR wound sample collection for mobile healthcare providers. Proper training and adherence to protocols ensure accurate results and better patient care.