Occult Blood in Stool                 MCL Procedure for Waived Applications
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Patient Specimen Collection Instructions

• When your doctor asks you to bring a stool specimen it is usually because he is looking for blood— which could indicate intestinal bleeding— or he is looking for parasites (worms) that cause diarrhea. You must take care in collecting the specimen so that the lab will be able to do an accurate test. To give accurate information, the lab must test three separate bowel movements; each one collected at least one day apart. Do not collect all three from one day— wait at least one day between each collection.
• Do not take specimens out of the toilet and do not mix the specimen with urine— both of these activities will mess up the lab tests. Instead, have your bowel movement in a clean, dry container or onto clean dry paper. Then, take a small amount and place it into the jar provided. Do not fill the jar to the top— one-half jar is plenty enough.
• Screw the cap on tightly, so that the jar can't leak and write your name, the date and the time on the label provided. Stick it to the jar so that we will know who it belongs to and store the samples in your refrigerator while you wait to get all three.
• The collection of stool specimens can be embarrassing and inconvenient, but doing it the right way will help the doctor help you.

Testing:

• Smear: Apply a thin smear of stool inside box A and B of the patient side of the test.
• Close the flap: The flap must be closed for at least three minutes before testing. The test may be stored for a maximum of two weeks.
• Develop: Give each smear two drops of developer.
• Timing: Read within 60 seconds.
• Interpretation: Any trace of blue color either on or at the edge of the smear is positive.
• Performance monitor: Add one drop of developer to each performance monitor pad and read within 10 seconds. Do this after running the patient test to check the reagents. Confirm that the + reads positive and the – reads negative. Failure of either performance monitor invalidates the patient results (see below).
• Failures of the performance monitors must be recorded and corrective action taken. The reagent must be replaced and the test repeated. If that fails to correct the difficulty, obtain new test pads and repeat. All repeated failures must be reported by a nursing problem report to be forwarded to pathology for full investigation and corrective action.
• Record the results: Write your name, the date, time and findings on the patient record.

Quality Control:

• The performance monitors must be read and must be acceptable before any test is accepted.
• Repeated failures of the performance monitors must be documented by nursing service report and forwarded to the laboratory for full investigation.
• External quality control in not necessary for this procedure.