UC Irvine Pathology Services has established a uniform policy for specimen acceptance/rejection that: Show
To protect patients from adverse errors made due to improperly labeled specimens, the laboratory policy demands that proper labeling criteria are always met. Every specimen brought to the laboratory must have a label on the container in which it is held. It is not acceptable to label only the lid, transport bag, or other container used to transport the specimen. The label must contain the following legible information:
When available, use the addressograph to enter all data on a prepared label being sure to fill in the additional information required that is not on the addressograph plate. For patient safety, it is essential that the following be adhered to when submitting blood specimens for CROSSMATCHING purposes. Use special pink-top (EDTA) tubes.
If the Blood Bank does not have a previous ABO/Rh on file for the patient, and the patient's initial blood type is other than type O, the Blood Bank will request a second sample to be collected for an ABO/Rh confirmation. Failure to properly label the tubes will require that the specimens be redrawn. If the patient requires blood as an emergency and another sample cannot be drawn, an Emergency Release Form must be signed for uncrossmatched group O blood. Specimens must be accompanied with a specimen transmittal or clinic encounter form that must match the specimen label. All handwritten requisitions accompanying specimens must have the following legible information:
Specimens must be submitted in the correct tube type or appropriate transport material in a leak-proof container. It is the caregiver’s responsibility to understand the correct specimen and transport requirements prior to collecting specimens. All patient specimens MUST be placed in biohazard bags for transport to the Laboratory. Laboratory procedures will not be performed on unacceptable specimens. Specimens collected using the incorrect tube type and transport material will not be tested. Specimens received showing evidence of leakage will not be tested. The nursing station from which the specimen originated will be notified. Mislabeled Specimens Specimens received unlabeled, double labeled, or with a requisition bearing a name and/or medical record number different than what is affixed to the specimen will not be tested. The patient’s nurse and/or physician will be notified to recollect the specimen.
A specimen is incompletely labeled if some of the required information is missing:
Specimens identified as precious specimens such as ascites fluid, amniotic fluid, cerebrospinal fluid, joint fluid, pleural fluid, surgical tissue/aspirate and certain timed specimens where the specimen cannot be recollected without undue harm to the patient will be tested only if the following conditions have been satisfied:
Receipt time of the specimen in the laboratory will be the time all information is obtained, not the time the incorrectly submitted specimen was first brought to the laboratory. The Blood Bank requires a new specimen for each unlabeled or mislabeled specimen, no exceptions. What are the considerations for specimen collection?Safety and Disposal Considerations in Specimen Collection
There are four steps involved in obtaining a good quality specimen for testing: (1) preparation of the patient, (2) collection of the specimen, (3) processing the specimen, and (4) storing and/or transporting the specimen.
What precautions must be followed in the handling of the specimen?1. Always wear gloves and any other indicated barrier protection when collecting and handling laboratory specimens. 2. Place each laboratory specimen in an appropriate leak-proof primary container (e.g. vacutainer tube, specimen cup, etc.).
What is the importance of proper specimen collection and handling?Specimen Integrity is dependent on accurate pre-analytical processes to include patient preparation, specimen collection, handling, and transportation. Improper collection and handling of samples can give erroneous results and compromise the care of the patient.
What is the most important step in specimen collection?Pre-centrifugation Handling - The first critical step in the lab testing process, after obtaining the sample, is the preparation of the blood samples. Specimen integrity can be maintained by following some basic handling processes: Fill tubes to the stated draw volume to ensure the proper blood-to-additive ratio.
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