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Specimen Collection Information

ACCEPTABLE SPECIMENS:

A correctly collected and preserved specimen submitted for laboratory testing is the key to the healthcare provider obtaining the information he or she needs to properly diagnose and treat a patient.  If a specimen is not collected in the proper manner, then the laboratory results will be incorrect and lead to the possibility of a misdiagnosis.

Utilize proper phlebotomy techniques to prevent hemolysis or a false decrease or increase in certain test values due to the tourniquet being left on the patient too long.

All specimens must be legibly labeled with the patient's first and last name, date of birth, family member prefix (FMP) and entire Social Security Number (SSN).  Microbiology and surgical specimens must have the source of the specimen written on the label.  Blood bank specimens for transfusion testing must be signed and dated by the phlebotomist.

The Laboratory will try to accession and test any specimens received that do not meet the criteria established above.  Any specimens that we cannot determine who the specimen belongs to will be either logged in CHCS under HOLD Test or in a manual log book.  Statistics for these incidents are reported to the Pathology Quality Improvement Committee and the hospital Quality Support Division.

 

UNACCEPTABLE SPECIMENS:

Incorrect or unacceptable specimens WILL NOT BE RETURNED to the clinic/ward for correction.  Under NO circumstances will the lab personnel correct specimens.  The following specimens are considered unacceptable: 

  • grossly hemolyzed blood samples
  • cracked, bloody and/or leaky specimens
  • anticoagulated specimens containing clots
  • specimen in the wrong tube or container
  • tube or container not labeled with the patient's full name/FMP/SSN
  • specimen not transported to lab under proper conditions
  • syringes containing any needles, lab will not accept specimens with needles attached (i.e., caths, fluids)
  • specimens improperly handled before arriving in the lab
  • tube or container without a test request form or order entry in CHCS
  • blue top tube which is incompletely filled or overfilled
  • purple top tubes, (i.e., CBC) must contain 75% of the expected draw
  • microbiological specimen received in a nonsterile container
  • cytology specimen not properly identified or without clinical data on request
  • cytology and surgical specimens received in inappropriate fixative
  • improperly collected/handled specimen for Anaerobic culture

NOTE:  Frequently the Laboratory receives samples without request forms or order entry into CHCS.  The Laboratory will make a reasonable effort (i.e., refrigerate, centrifuge) to salvage any sample which has not been compromised and otherwise would be.  The Laboratory will make a reasonable effort (with documentation) to contact ordering provider/unit and request order for lab tests to be made.  When reasonable effort has been unsuccessful or sample compromised, the specimen(s) will be discarded.  A message will be sent to HCP group informing providers status of such specimens and advising that the specimen be resubmitted, if deemed clinically necessary.  If an improperly labeled specimen is determined to be compromised and retrievable, the requesting center will be contacted to request a new, properly identified specimen and request form or order entry.  The specimen will then be discarded.

Examples of retrievable specimens are:

  • Routine Blood Specimens
  • Routine Throat Cultures
  • Routine Urinalysis
  • PKU's

 

Examples of irretrievable specimens are:
  • Wound Cultures/Anaerobic Cultures
  • CSF
  • Blood Cultures 

 

A physician may request to reverse the above decision; however, this will be regarded as an exception, in emergency situations only and will be accomplished only after consultation with a staff pathologist.  It is assumed that physicians will understand the malpractice implications of overriding the above decisions and will utilize this option only in EMERGENCIES. Please note that a disclaimer will be applied to any specimens overridden by physicians.

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