laboratories sample handling

8/17/2019 Laboratories Sample Handling

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Directorate of Laboratory Medicine 1

Sample handling

Malcolm Dunlop

Directorate Quality Manager


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Clinical Sciences Building 1


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Clinical Sciences Building 2


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Laboratory Departments

Typical DGH

• Clinical Biochemistry (Chemical

Pathology)• Haematology

• Histopathology

• Microbiology


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Laboratory Departments

Teaching hospital / tertiary referral• Clinical Biochemistry (Chemical Pathology)

• Haematology

• Histopathology

• Microbiology

• Immunology

• Virology

• Sub Fertility associate !epartment

• Cytology

• "thers e#g# $enetics


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What constitutes a sample

• %ny biological material ta&en 'rom a

patient 'or !iagnostic prognostic ortherapeutic monitoring

• n!er the ne* Human +issues %ct

tissue inclu!es• bloo!• urine , other 'lui!s

• 'aeces

• s*eat

• semen

• tissue


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Infection risks

• %ll samples must be consi!ere! to be

in'ectious• se o' -ni.ersal Precautions/

han!ling

• 0e.er assume any sample is -safe” • +o!ay1s symptoms may be

tomorro*1s !iagnosis o' in'ection


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Phases of analysis

• Pre2analytical ('rom the patient to the

lab)• %nalytical

• Post2analytical ('rom the lab to the

notes)


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From the patient to the lab

• 3hat can (an! !oes) go *rong

• Incorrect i!enti'ication o' patient• Patient preparation 'asting !iet

supine time !rugs#

• Sample poorly4 incorrectly ta&en• Inaccurate timing

• 3rong type o' sample


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From the patient to the lab

3hat can (!oes) go *rong5

• Incorrect container(s)• n!er2'illing

• Mislabelling4 no labelling

• Incorrect storage4 transport (ice*arm !elay)

• 6oss brea&age etc#


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he Patient

• Do patients al*ays !isclose history5

• Con'use!• Frightene!

• In pain

• 3ant to help 777

• %re pre.ious !iagnoses a.ailable5


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!uality

• 6aboratories can only pro!uce8uality results on 8uality samples

• %n! on 8uality re8uests

• Rubbish In Rubbish Out• I!eal sample mimics the in .i.o state


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"e#uesting

• 9e8ueste! on P%S : electronic return

• 9e8ueste! manually : 0" electronicreturn

• ;lectronic4 manual mi


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"esults

• +elephone! results are the most

unsa'e metho!• ;lectronic are sa'est an! 8uic&est

• Har!copy reports must be 'ile! as

per instructions


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Blood collection

• %s& patients to i!enti'y themsel.es

• 3hen bloo! ta&en *rite all rele.ant!etails on collection tubes

imme!iately


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ample acceptance

• Patient sa'ety is o' the utmost

importance• Samples an! re8uests MS+ allo*

clear i!enti'ication the patient

• Samples i!enti'ie! incorrectly *ill0"+ be processe!


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ample acceptance

• +he sample MS+ inclu!e patient1s=2

– Surname – Forename

– Date o' Birth or Hospital 0umber or 0HS

number

– Histology specimens MS+ inclu!e

Hospital number


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$ther information

• SH"6D inclu!e

– 3ar!

– Date o' collection

– +ime o' collection e#g# Cortisol


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ample acceptance

• 9e8uest 'orm MS+ contain

patient1s=2

– Surname

– Forename – Date o' Birth an!4 or Hospital or 0HS

number

– 3ar! or clinic

– +ests re8ueste!


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amples for Blood ransfusion

• M%0D%+"9> i!enti'icationre8uirements

– %s pre.ious plus signature an! printe!

name o' re8uestor on 'orm – Signature o' person collecting the bloo!

on the sample tube(s) an! on re8uest

'orm

– Date o' re8uest an! o' sample

• See Bloo! +rans'usion Policy


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Venous bloo! sampling

Syringe Hybri! ;.acuate!


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Blood collection

• se the bloo! collection system in

use• %!.antages o.er nee!le , syringe

– Higher 8uality sample

– Minimises clotting mechanism

– Pro!uces correct bloo! to anticoagulant

ratio *hen properly 'ille!

– ;asier

– Quic&er


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ampling problems % blood

• Inappropriate site !rip arm

mastectomy burns etc• +iming

• Incorrect use o' tourni8uet

• 3rong container • Incorrect or!er o' !ra*

• +ransportation


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&rine collection

• ?@ hour sample must inclu!e all urine

passe! in this perio!• I' less than ?@h in'orm the lab

• Mi! stream sample sel' e


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&rine samples

• Incorrect timing

• Inappropriate 'or test re8uire!• Sterility

• Volume


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$ther considerations

• S*abs 'or culture may nee! speci'ic

transport me!ia e#g# Chlamy!ia• Bloo! cultures special bottles ,

techni8ue 'or ta&ing the bloo!

• +issue 'or Histology 'i


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laboratories sample handling

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