19.10 Checklist for Oropharyngeal Testing

Use the checklist below to review the steps for completion of “Oropharyngeal Testing.”

Steps

Disclaimer: Always review and follow agency policy regarding this specific skill.

1. Gather supplies: testing kit or swab, gloves, tongue depressor, mask, and penlight or flashlight. Other PPE such as a face shield, respiratory, or gown may be required based on the patient condition.
2. Perform safety steps:
   • Perform hand hygiene.
   • Check the room for transmission-based precautions.
   • Introduce yourself, your role, the purpose of your visit, and an estimate of the time it will take.
   • Confirm patient ID using two patient identifiers (e.g., name and date of birth).
   • Explain the process to the patient and ask if they have any questions.
   • Be organized and systematic.
   • Use appropriate listening and questioning skills.
   • Listen and attend to patient cues.
   • Ensure the patient’s privacy and dignity.
   • Assess ABCs.
3. Apply nonsterile gloves. Inform the patient the procedure may be uncomfortable and cause gagging.
4. Open the supplies.
5. Ask the patient to open their mouth wide and tilt their head back. Using a penlight, inspect oral cavity, pharynx, and tonsils for redness, swelling, pus, or red spots.
6. Insert the tongue blade to depress the tongue. If the patient can depress their tongue so that it is out of the way of the swab, the tongue blade may not be needed. Some patients have a strong gag reflex and may resist swabbing. If gagging occurs, stop the procedure, and allow the patient to rest. Attempt again, but ask the patient to focus on the ceiling or close their eyes to facilitate swabbing.
7. Insert the swab into the posterior pharynx and tonsillar areas. Rub the swab over both tonsillar pillars and posterior oropharynx and avoid touching the tongue, teeth, and gums.
8. Place the swab in the sterile tube and snap the end off swab at the break line. Place the cap on the tube.
9. Label the tube with the patient’s name, date of birth, medical record number, today’s date, your initials, time, and  specimen type.
10. Place the specimen into the biohazard bag.
11. Remove nonsterile gloves and place them in the appropriate receptacle.
12. Perform hand hygiene.
13. Assist the patient to a comfortable position, ask if they have any questions, and thank them for their time.
14. Ensure safety measures when leaving the room:
    • CALL LIGHT: Within reach
    • BED: Low and locked (in lowest position and brakes on)
    • SIDE RAILS: Secured
    • TABLE: Within reach
    • ROOM: Risk-free for falls (scan room and clear any obstacles)
15. Follow agency policy regarding transportation of the specimen to the lab. Report results appropriately when they are received.