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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