Specimen Collection

• Before collecting a specimen from any patient, that patient must be correctly identified as being the correct patient using bed number, patient chart, patient hand band or other means necessary
• All procedures for collecting a specimen must be closely adhered to as to provide the best quality specimen
• It is best to collect any specimen before administering medication, especially antibiotics for microbiological specimens
• Avoid as far as possible drawing blood from the same arm with IV or other infusion lines. This practice has the potential to compromise patient test results

Patient samples must be labeled accurately and correctly at all times and correspond exactly to the identification on the request form. This cannot be over emphasized. The following suggestions should be taken into consideration when collecting and labeling patient specimens:

• Always label the specimen at the patient bedside or at the same location where the specimen is being taken
• Immediately after taking the patient specimen label the specimen container(s)
• Never label the specimen container before reaching the patient bedside or after leaving the bedside
• Label the specimen containers clearly and legibly
• The patient name / code, type of specimen, date and time should be on the label of the container
• Remember the identification on the specimen must correspond to that on the request form
• Samples must be coded in accordance with the National Coding System. The National Code consists of:
  • Patient first and last name initials —MF
  • Patient’s mother first and last name initals —CF
  • Patient’s gender – M/F
  • Patient’s date of birth – YYYY/MM/DD — 1974/12/26
  • e.g. MFCFM1974/12/26

The Procurement Officer, is responsible for the distribution of specimen collection containers to the different departments of the Tapion Hospital, all doctors offices, the various Laboratory locations and out patients.

• Containers and supplies can be collected on the following day of the request

See below for a description of the specimen collection containers.

The classification of a sample being replaceable or irreplaceable is defined below. Exceptions of this should be made at the discretion of the ordering provider in conjunction with the laboratory supervisor or charge person.

1. Replaceable samples — Blood, urine and gynecologic cytology samples (pap smears)
2. Irreplaceable samples — Tissue, non-gynecologic cytology samples, body fluids, CSF and some timed blood/urine samples

The following are criteria for rejection of samples:

1. Not labelled with a minimum of Full Patient Name, and identifying number (DOB)
2. Sample has exceeded established time limits for preservation
3. Sample has been collected in an inappropriate container, preservation or anticoagulant
4. Sample has been collected in an inappropriate manner (i.e. tube improperly filled or clotted samples in anticoagulant tubes)
5. Special preparations not followed before sample was collected e.g. Semenalysis, Occult Blood
6. Sample is in a sample container that is broken or leaking (slides broken)
7. Sample not transported within required temperatures
8. Are in expired transport media
9. Are submitted without transport media or in an improper transport medium
10. Are not received within a time frame optimal for the organisms for which isolation is being attempted

When unacceptable samples are received, laboratory personnel will notify the ordering provider of the rejection.

1. Replaceable samples will be discarded
2. Irreplaceable samples –
   • Laboratory personnel will notify the ordering provider and request an appropriate individual to come to the laboratory to identify the sample and correctly label the sample
   • The individual will be required to complete and sign an Identification of Irreplaceable Specimen form (SC-LF-IrrSpecimen)
   • If the provider is off-site, the sample, requisition and an Identification of Irreplaceable Specimen form (SC-LF-IrrSpecimen) will be sent back to the provider

1. Samples that are missing other required information (other than missing and / or discrepant patient identifiers) will be held and NOT PROCESSED until the appropriate information is obtained from the ordering provider or appropriate clinical staff
2. Samples that are missing required information may incur delays in sample processing and reporting until the required information in obtained
3. Some smaple processing delays may results in the sample not being able to be processed if it exceeds established time limits for preservation

Examples of missing information may include:

• Not accompanied by a complete written requisition form
• Missing initials of the collector
• Missing collection date and time on the sample container/requisition form
• Missing source/site information when required
• Missing clinical information when required

In addition, specimens for culture will be rejected if they:

• Are submitted without transportation medium or in an improper transport medium (i.e. transport medium that could compromise results)
• Are not received within a time frame optimal for the organisms for which isolation is being attempted, exception being reference isolates
• If the submitter of any specimen has not completed the test requisition, the testing shall not be performed until the completed test requisition is received. The submitter shall be contacted by telephone to clarify the test requisition

• Laboratory Services offers phlebotomy services at all locations during routine working hours
• Home phlebotomy services are also available by appointments
• The Specimen Collection Department collects, sorts and records all specimens received by the Laboratory. Samples are received from our out-locations and other clients

• Send all specimens are soon as possible to the laboratory
• If specimens cannot be sent at once, store in a refrigerator (except blood cultures, Spinal Fluid, urethral and cervical / vaginal swabs)
• Delay in sending samples to the laboratory may lead to deterioration of sample and hemolysis if clotted blood is sent
• The closure of containers must be tight to prevent leaking
• Samples must be clearly labeled
• Specimens being transported must be placed in a leak-proof container and placed in the biohazard bag
• Completed Requisition Forms must accompany samples to the laboratory. Place form in the outside pouch of the bag