1. CHLAMYDIA / GONORRHEA Vaginal Specimen Collection and Form Training NC State Laboratory of Public Health 2015

2. Chlamydia / Gonorrhea Training Objectives This training was developed to provide instruction in the collection of vaginal specimens for chlamydia/gonorrhea testing and the completion of test request form DHHS #4011. At the conclusion of the training, participants should be able to: Determine if the patient meets the testing criteria established by the laboratory Correctly complete the test request form to accurately indicate testing eligibility Properly collect a vaginal specimen and submit the specimen to the laboratory using the GenProbe vaginal specimen collection kits Recognize reasons for unsatisfactory Chlamydia/GC test results because of improper collection or submission

3. NCSLPH CT/GC Testing Criteria Screening test criteria have been established so that limited available funding is used to test the most affected patient populations.

4. Who is Tested? Women aged 25 years old and under Women of any age who have symptoms Pregnant women Women with a high-risk history (new partner or multiple partners) Women having an IUD inserted Women with contact to a known positive case Retest of a positive result three months later

5. Completing the Test Request Form (DHHS #4011) Matching patient information on the request form and specimen tube ensures positive identification of the patient specimen and accurate reporting of results Certain information provided by the submitter such as patient signs and symptoms, pregnancy status, and reason for testing is required due to limited resources, Filling out the form correctly prevents delays in testing and the need for the patient to return for recollection

6. Chlamydia / Gonorrhea Detection Request Form (DHHS #4011) The top two sections contain patient demographics and submitter information. ► The middle section contains information about the patient visit. ► The next section contains instructions. ► The bottom section contains an area for laboratory use only. ►

7. Instructions for Completion of DHHS 4011 Two pages of instructions are posted on the SLPH website along with the form.

8. Most of the information in the top two sections may be written in OR a typed label may be affixed in the box on the right side of the form.

9. THIS SECTION MUST BE COMPLETED  Fill in this section completely, including reason for visit, signs/symptoms, and pregnancy status. Please refer to testing criteria when completing this information.  This information is required for all patients, regardless of the patient’s age or the clinic in which the patient is seen.  Note that urine testing is available only to certain pre- approved testing sites.

10. Specimen Collection The video clip that follows will demonstrate the proper collection of a vaginal swab specimen. Click the picture below to access the video.

11. Vaginal Specimen Collection Important Reminders The vaginal collection kit consists of an orange- labeled tube and a pink- shafted swab The swab has a gray scoreline halfway up the shaft The swab MUST be broken directly on the gray scoreline or the specimen will not be acceptable for testing

12. Labeling the Specimen Tube The specimen tube may be labeled by hand or a typed label may be applied The label MUST contain the full patient first and last name and a second identifier, which may be a date of birth or patient ID number such as SSN This information must also be on the form and must match exactly

13. Incorrect Vaginal Collection (Example 1) This swab was broken above the gray scoreline and is too long. It will not lie properly against the side of the tube and may jam the instrument pipettor.

14. Incorrect Vaginal Collection (Example 2) This swab was broken so far above the gray scoreline that it broke through the foil cap, which was then taped. It leaked on several other specimens, and they also had to be discarded.

15. Collection Tube Expiration Important Reminder!  Specimen collection tubes show an expiration date on the label  Specimens may be collected up to and including the date printed on the tube

16. Collection Tube Stability Vaginal collection kits are available via online ordering from the State Laboratory Mailroom Prior to use, vaginal collection kits should be stored at room temperature Once collected, vaginal specimens are satisfactory for testing when held at room temperature for up to 60 days Vaginal specimens should promptly be transported to the State Laboratory at ambient temperature

17. Questions? Specimens that are properly collected and submitted with accurate and complete paperwork will assure timely testing and reporting of results. If you have questions, please call the Bacterial STD Laboratory at 919-733-7544. Thank you!

18. To receive CEU credit… To receive a CE certificate for 1.0 contact hours you must create a FREE student account and complete the online quiz. Once you have created the account you will be linked back to this class page. You may wish to print this page for reference by selecting the following keys on your keyboard: [Ctrl] + P You must first register for this class: Class: Chlamydia/Gonorrhea Specimen Collection and Form Training Code: EGP477 Step 1. Go to the Quia website at http://www.quia.com/web. Step 2. Now, click the area labeled Students. When the next page appears, enter your username and password if you already have a Quia account. If you do not have an account, click the link Create my free account. Fill out the form that appears. Select "Student" as the account type. When you are done, press the Create my account button. Step 3. You should now be in the Student Zone. Type in the class code EGP477 in the text field and press the Add class button. Now you're done! Now that you have registered for your instructor's course, you can view your class web page, take quizzes, view your quiz results, view time spent on Quia activities, and read your instructor's feedback from your Quia account.