UHB

Transport of Specimens 

Pathology specimens should be sent via the sample delivery system to the laboratory or delivered by hand and left at the reception desk. 

All samples sent to the laboratory should be packed so as to comply with the Carriage Dangerous Goods (Classification, Packaging and Labelling) Regulations 1996

General Guidance

• Specific transport requirements are identified where applicable in the test database for individual tests. Please check here if you are unsure.
• Use containers provided by the Trust. These are designed to be robust and not leak in normal use.
• Ensure that the container is appropriate for the purpose, is closed and not contaminated on the outside.
• After labelling, the samples should be placed in individual plastic transport bags and sealed, not secured with clips or staples
• Please do not place the request form with the sample, instead separately in the side pocket.

Samples may be sent to the Laboratory in the following ways:

On site transport

• Specifically designed for purpose, specimen transport bags/boxes are used to transport samples within the Trust, by an on site portering service to Pathology reception
• If a spillage occurs and is not contained within the specimen transport carrier please ring the number provided on the side of the box and assistance will be provided.
• Do not leave a spill unattended
• A pneumatic air tube system can be used to transport samples. This system should not be used to send urgent Microbiology samples such as CSFs as it is possible these samples may go astray resulting in a delay in processing and therefore provision of results. Samples containing large volumes of liquid (>50ml) should not be sent by tube because disinfection following leakage is extremely difficult to achieve.

Off site arrangements

• There is a daily courier pick up system, provided by the Trust for General Practitioners.
• This service is subject to safety audit and inspection. Assistance for dealing with spillage can be obtained by phoning the numbers on the transport carriers.
• There is a Hospital transport system linking the laboratory to other hospitals and clinics Trust wide.

Minimum Dataset for Completing Request Forms

Ensure that the request form is legible and completed as fully as possible. The correct request form must be completed and must accompany any specimen to the correct laboratory. Both the specimen label and the request form must contain the appropriate minimum data set.

There must be:

• Unequivocal identification of the patient and matched to the specimen to the request - bear in mind the regional and cultural predominance of certain common names;
• Sufficient information to allow the specimen collector to make the correct choice of timing, specimen to collect (specimen type) and container to use;
• Sufficient information to identify the exact site of sampling (e.g. for biopsies, some culture swabs, etc.). Where different sample sites are included on one request form the site of each specimen must be unequivocally noted on the specimen label also;
• Sufficient information to aid the audit trail of a specimen from request to laboratory;
• Sufficient clinical details to allow laboratory interpretation of the result an analysis, including any current condition or therapy that might interfere with analyses.
• Time of sample collection ~ for some assays the time a specimen has been in transit can greatly affect the quality of the result.

All details on the request card should be completed including details of current therapy. Please include the NHS number if known on both the request card and specimen bottle. If printed labels are available please double check you are using the correct one: the large label with the bar code should be applied to the request card and the small labels attached to the specimen containers. You must ensure that the correct location is entered on the request card. Failure to record this will mean that a report cannot reach the patient’s notes. This is particularly important if the patient has moved and labels from the previous location are used, you must ensure that the correct current location is entered on the label. Where a two-part form is used please ensure that information is legible on both parts of the form.

NB: it is not acceptable to use a pre-printed label on a specimen for transfusion purposes, this must be handwritten, legibly and unambiguously.

Poorly labelled or mismatched specimens may not be analysed for medical legal reasons.

It is a requirement of the Blood Safety and Quality Regulations that the blood bank and pathology reception operate zero tolerance with regards to the minimum data set requirement for blood transfusion product requests forms and sample labelling.

1.1.       Specimen Tracking

A specimen tracking audit trail is crucial (for quality assurance, clinical governance clinical governance and medical-legal reasons).

There must be a traceable history and "chain-of-custody" which should include:

• the identification and location of the responsible clinician ordering the test;
• the analytical tests/examinations required;
• the patient, location and medical specialty (i.e. the original source of the specimen unambiguously identified);
• the person collecting the specimen with the date and time collected;
• the nature of the specimen collected (and if appropriate, anatomical site of origin);
• the analytical tests required;
• the laboratory undertaking the analysis;
• identification of priority status;
• where the results should be sent (if different from above);
• the resulting analytical data relating to that specimen (and sub-samples thereof);
• the reported result.

1.2.       Minimum Data-set

Data on the request form and the specimen must be compatible. All specimens must carry a minimum, legible and compatible data-set on both the request form and the specimen label.

Certain specimens labels may have insufficient room to physically allow a full data set in this case include as many key identifiers as possible.

Additional information may also be required such as notification of known or suspected biohazard of the specimen, priority of the result (or date required if for Cellular Pathology), or to aid the reconciliation of the patient with a record on ‘Lorenzo’ or in the patient’s notes.

Time of collection is crucial in several circumstances, including:

• To assess the suitability of a sample for tests where cellular degradation over time (e.g. K⁺ leakage) may interfere or give an incorrect result.
• For tests that are part of a timed series (Dynamic Function Tests, e.g. Glucose Tolerance Tests, Endocrine Function Tests etc.),
• To allow the laboratory to properly audit specimen turnaround times.

If sufficient clinical details are not provided then the laboratory will not be in a position to offer an interpretation of the result of the test or examination, in this case the laboratory will note this on the report.

If patient anonymity is important a properly coded identifier may be used but this has to be part of a documented system which properly and unambiguously identifies the patient.

Computer software systems may be in use within the Trust (e.g. PICS) which are capable of generating patient specific printed labels. The use of computer generated patient identification (PID) labels for the request form and specimen introduces a risk of misidentification under certain circumstances. Always double check that the correct label has been affixed to the correct request and is accompanied by the correct specimen.

NB: it is not acceptable to use a pre-printed label on a specimen tube for transfusion purposes; this must be handwritten, legibly and unambiguously.

If and when barcodes might be used to identify a request and specimen or sample, these do not replace the requirement for adequate labelling, but in addition the barcode on the specimen and the request form must be identical.

In exceptional circumstances where the minimum dataset is impossible to collect, such as an unidentified patient attending casualty, the laboratory may process the request but will make it clear on the report supplied that necessary data is missing for the unambiguous reconciliation of the patient with the sample received.

Raising Concerns about our Services

Customers may raise concerns through various methods such as phone calls, visits, letters. Specific clinical or technical queries should be via the appropriate Laboratory Manager or Duty On-Call Biomedical Scientist (whichever is most appropriate) – see Department Contacts for details.

Alternatively you may contact the Patient Services Department via email This email address is being protected from spambots. You need JavaScript enabled to view it. or through a single new hotline number 0121 424 0808. Formal complaints are addressed by the instigation of the Trust Complaints Procedure

Opening Hours

Weekdays

A full laboratory service is available from each department between 8.00 and 20.00 weekdays but each individual laboratory may have extended core service times; please consult each section for details. Specimens for routine analysis should be submitted as soon as possible to the individual laboratories.

Saturdays

A more limited laboratory service is available in the following laboratories.

• Clinical Biochemistry
• Laboratory Haematology
• Clinical Microbiology

Samples requiring analysis for daily monitoring purposes should reach the laboratory by 11.00 so that they can process by the staff available. Samples sent after this time for routine analysis will be processed in strict order and after dealing with true emergency samples. Some specialist biochemistry investigations can be performed by prior arrangement with the laboratory, and should reach the laboratory earlier in the day. A limited number of staff work in the laboratories on Saturday morning. Investigations should be restricted to those patients who require monitoring to alter or prescribe therapy for that day. The Specimen Delivery System is available for sending most specimens. There are limited collections by the portering staff. Ad hoc porters can be called to take urgent specimens to the laboratory specimen reception. Transport should be contacted directly if the specimen cannot wait. Tests requiring urgent analysis should be brought to the attention of the laboratory staff by a prior telephone call.