Made with Xara © Arkansas Pathology Associates 2010 HPV- Screening and Genotyping Precaution Collect Pap test specimen before obtaining specimen for DNA testing if using the Cervical Sampler Procedure.  Collect DNA specimen prior to application of acetic acid or iodine if a colposcopy will be performed.  ThinPrep Pap Test Procedure Materials Needed 1.  Vial of ThinPrep PreservCyt Solution:  Write the patient’s name on the vial. 2.  Collection devices:  Broom-like device or endocervical brush/spatula. 3.  Speculum:  Use water; not lubricant, on speculum and shake off excess. 4.  APA requisition form:  Complete the form with the following information:  patient’s name, age or date of birth, SSN, source of specimen, LMP, menstrual/pregnancy history, previous Pap history, treatment history, physician’s name and billing information.  Mark HPV as the test requested on the form. 5.  Specimen transport bag:  Place specimen in bag and seal.  Place the requisition form in the pouch part of the bag. Specimen Collection and Preservation 1.  Specimens should be collected in the same manner as a ThinPrep Pap test. 2.  PreservCyt Solution specimens may be held for up to three weeks following collection and prior to processing for the HPV test. Transportation 1.  Place the vial in the specimen transport bag and seal.  Place the requisition form in the pouch outside the sealed bag. 2.  Transport specimens to the cytology laboratory by courier.  If specimens are to be mailed, contact the cytology laboratory for instruction. Chlamydia & Gonorrhea, Herpes Simples Virus I/II, and Group B Strep Precautions 1.  Use only the swabs and transport tubes that come with the M4 STD Swab Collection and Transport Kit, PreservCyt, or plastic, preservative-free, sterile cup for urine specimen.  Culturettes  may also be collected for Group B Strep and Herpes Simplex Virus I/II.  The recommended collection for Group B Strep is to swab the lower vaginal area and the anal area for an adequate specimen. 2.  Transport tubes in which any of the transport buffer has spilled out should not be used. 3.  Do not use M4 STD Swab Specimen Collection and Transport Kit or PreservCyt beyond the expiration date. 4.  This product contains sodium azide as a preservative and is classified as HARMFUL (see MSDS for details).  Sodium azide has been reported to form lead or copper azide in plumbing and may explode on percussion, such as hammering.  Flush drains thoroughly with water after disposing of solutions containing sodium azide. 5.  Some spermicidal agents, feminine powder sprays, powdered gloves, and lubricants may interfere with PCR assays, and should therefore not have been used prior to collection of swab specimens. 6.  Swab specimens that are moderately bloody should not be tested since they may cause inhibition in PCR Assays. 7.  Swab specimens that are grossly mucoid should not be tested since they  may cause inhibition in PCR assays.  Therefore, it is important that the exocervix be wiped free of mucus prior to collection of the swab specimen to ensure optimal specimen collection. 8.  The effects on PCR assays by other potential variables such as vaginal discharge, use of tampons, douching, etc., and specimen collection variables have not been determined. Endocervical Swab Procedure Materials Needed 1.  M4 STD Swab Specimen Collection and Transport Kit or PreservCyt ThinPrep vial collection. 2.  Speculum-Use water, not lubricant, on speculum and shake off excess. 3.  APA Requisition Form-Complete the form with the following information:  patient’s name, age or date of birth, SSN, source of specimen, LMP, menstrual/pregnancy history, previous Pap history, treatment history, physician’s name and billing information.  Mark the Test Requested-Chlamydia and/or Gonorrhea.  If the requisition form you are using does not have a place to request this test, write it on. 4.  Specimen Transport Bag-Place specimen in the bag and seal.  Place the requisition form in the pouch outside the sealed bag. Specimen Collection and Preservation 1.  Remove excess mucus from the exocervix with the large-tipped cleaning swab provided in the M4 STD Swab Collection Kit and discard.  NOTE:  DO NOT USE THE LARGE-TIPPED CLEANING SWAB FOR SPECIMEN. 2.  Insert the small-tipped specimen swab into the endocervix and rotate the swab for 15 to 30 seconds to ensure adequate sampling. 3.  Verify that all swab specimen transport buffer is at the bottom of the tube.  If necessary, tap or shake the solution down to the bottom of the tube.  Unscrew the cap of the transport tube, insert the swab into the transport tube and break the swab at the score line.  Replace the cap securely, making sure that the swab fits into the cap and then screw on the cap until it clicks into place. 4.  Label the transport tube with the patient’s name and date of collection. Transportation 1.  Place the tube in the specimen transport bag and seal.  Place the requisition form in the pouch outside the sealed bag. 2.  Transport specimens to the cytology laboratory by courier.  If specimens are to be mailed, contact the cytology laboratory for instructions. 3.  Swab specimens can be shipped to the laboratory at 2-30° C.  Swab specimens must arrive at the laboratory within 24 hours of shipment. Male Urethral Swab Specimen Materials Needed 1.  M4 STD Swab Specimen Collection and Transport Kit for Males. 2.  APA Requisition Form-Complete the form with the following information:  patient’s name, age or date of birth, SSN, gender, physician’s name and health facility, billing information, date of collection, source of specimen, and clinical history.  Indicate the test requested-Chlamydia and/or Gonorrhea. 3.  Specimen Transport Bag-Place specimen in the bag and seal.  Place the requisition form in the pouch outside the sealed bag. Specimen Collection and Preservation 1.  Insert the small-tipped specimen swab 2 to 4 cm into the urethra and rotate the swab for 15 to 30 seconds to ensure adequate sampling.  NOTE:  DO NOT USE THE LARGE-TIPPED CLEANING SWAB FOR SPECIMEN COLLECTION. 2.  Verify that all swab specimen transport buffer is at the bottom of the tube.  If necessary, tap or shake the solution down to the bottom of the tube.  Unscrew the cap of the transport tube, insert the swab into the transport tube and break the swab at the score line.  Replace the cap securely, making sure that the swab fits into the cap and then screw on the cap until it clicks into place. 3.  Label the transport tube with the patient’s name and date of collection. Transportation 1.  Place the tube in the specimen transport bag and seal.  Place the requisition form in the pouch outside the sealed bag. 2.  Transport specimens to the cytology laboratory by courier.  If specimens are to be mailed, contact the laboratory for instructions. 3.  Swab specimens can be shipped to the laboratory at 2-30°C.  Swab specimens must arrive at the laboratory within 24 hours of shipment. Urine Specimen Procedure Materials Needed 1.  Plastic, preservative-free, sterile urine collection cup. 2.  APA Requisition Form-Complete the form with the following information:  patient’s name, age or date of birth, SSN, gender, physician’s name and health facility, billing information, date and time of collection, source of specimen, and clinical history.  Indicate the test requested-Chlamydia and/or Gonorrhea. 3.  Specimen Transport Bag-Place specimen in the bag and seal.  Place the requisition form in the pouch outside the sealed bag. Specimen Collection and Preservation 1.  Instruct the patient not to urinate for two (2) hours prior to collection. 2.  The patient should collect the first 10 to 50 mL of voided urine (the first part of the stream) in a plastic, preservative-free, sterile urine collection cup. 3.  Close the cup securely and label the collection cup with the patient’s name and date of collection. 4.  Refrigerate the specimen immediately at 2-8°C, or store frozen at -20°C or below. Transportation 1.  Place the cup in the specimen transport bag and seal.  Place the requisition form in the pouch outside the sealed bag. 2.  Urine specimens should be shipped to the laboratory or testing site at 2-8°C or frozen.  Specimens stored at room temperature should not be used for testing. 3.  Transport specimens to the laboratory by courier.  If specimens are to be mailed, contact the laboratory for instructions.