Effects of Appropriate Sputum Expectoration on Culture Studies in Emergency Department

ABSTRACT

PURPOSE: In clinical situations requiring the use or the sputum Gram stain test, the adequacy of specimens is often compromised by improper sample generation by patients. We designed a study to evaluate the effect of good written instruction for sputum expectoration on the outcome of sample adequacy. METHODS: Data were collected from adult patients over age 15 at a tertiary teaching hospital emergency department who had the sputum Gram stain test from October 1 to October 31, 2006. Patients were given carefully written instruction cards for sputum expectoration, together with a bottle of mineral water to gargle before expectoration. Patients' data were compared to a group of patients who visited the same ED during the same month in 2005. RESULTS: The total numbers of sputum tests were 164 in 2006 and 151 in 2005. The number and percentage of adequate specimens increased from 62(44%) in the 2005 patient group to 114(69.5%) in the 2006 patient group (p=0.000). CONCLUSION: By the simple use of properly written instructions for expectoration and of mineral water for oral gargling before sputum expectoration, the adequacy of sputum specimens for testing can be significantly improved.