Requesting pathology tests

Instructions for completion of the request form

Our laboratories have well-established acceptance criteria which need to be present for samples to be accepted and processed. All essential items need to be present on the form to ensure that patients are uniquely identified so that results are not allocated to the wrong patient, and that the correct test can be performed and reported to the correct clinician and sent to the correct location.

It is the responsibility of the requesting clinician to complete the correct request form fully. Errors or incomplete information WILL result in a delay in specimen processing and reporting.

To comply with laboratory procedures, we will only accept samples where all mandatory information and minimum patient identifiers are provided. The following essential information is required:

Essential criteria

  • NHS Number / Hospital Registration Number
  • Surname
  • Forename
  • Date of Birth
  • Identification and location of the requestor
  • Investigation required
  • Date and time of collection
  • Specimen Type, where appropriate the anatomical site of origin
  • Relevant clinical information
  • Fasting or dietary status
  • The date of the onset of symptoms or date of contact
  • Details of antibiotic therapy and drug therapy
  • Biohazard warning label

Desirable criteria

  • Patient address
  • Recent transfusion history (where relevant)
  • Any anticoagulant agents administered
  • Contact phone number/bleep
  • Indication of the urgency of the request
  • Gender
  • Medical Specialty
  • NHS/PP category

Transfusion requests for blood grouping and cross-matching must use the dedicated transfusion request form. The same criteria apply including the name of the person taking the sample.

Requesting tests

Electronic Requesting

Please use ICE requesting whenever possible.  All requests for blood products at VCH must be made through ICE. the use of electronic requesting for all blood grouping and product requests.

Emergency Requests

Urgent requests must be confined to specific tests that will immediately affect the management of a case. Urgent requests must be marked on the request form. Unlabelled and mislabelled specimens will not be accepted.

For histopathology specimens, it is advised that you contact the department before sending the sample.

Verbal Requests

To make a verbal request, please contact the relevant department and speak to a member of staff.

Acceptance and Rejection

For more details please see the handbooks on our services page.

Transportation of samples

All specimens must be handled with care and treated by all personnel as a potential infection risk. However, additional precautions are required for samples deemed to be high-risk.

Low-Risk Diagnostic Specimens (UN3373)

The majority of specimens collected and transported to the pathology departments do not present a significant risk of infection to the staff handling them. These may be considered “low-risk” diagnostic specimens. Such specimens will normally be packaged in a primary container (e.g. blood tube, swab tube, specimen pot), and an outer secondary container (a sealed pathology transport bag or sealed plastic bag). All specimens must be accompanied by an accurately, fully completed pathology request form which must preferably be integral and external to the bag. The tertiary container used to transport specimens around and between hospitals may vary in design but must comply with the P60 specification outlined in this Policy.

High-Risk Infectious Specimens (UN2114)

Some patients may be suffering from, or be suspected of having a disease which may present higher risk to staff. Legislation requires specimens from such patients to be identifiable. 

•    The specimen containers and pathology transport bags used for these specimens will be identical to those used for routine specimens. The identification of risk associated with these specimens will be by the use of “DANGER OF INFECTION” labels. The specification for these labels is given in Appendix C.

•    It is the legal responsibility of the person who requests the laboratory examination of the specimen to ensure that both the request form and the container are correctly labelled to indicate a danger of infection. “DANGER OF INFECTION” labels must only be used for specimens which are suspected of or are known to contain pathogens.

Internal Transport

Birmingham Women’s Hospital

Method

Summary

Routine

Samples are collected from designated points by pathology staff on weekdays only

Urgent

Hand-deliver to specimen reception

Air tube

Available 24/7. Not to be used for:

  • Blood products
  • Histology specimens
  • Blood culture bottles
  • Known high-risk specimens
  • Blood glass samples

 

Birmingham Children’s Hospital

Method               

Summary

Routine

Mon-Fri

Samples are collected from designated points by pathology staff.

Routine

Weekends & Bank holidays

Collected from ED and ITU only

Urgent

Hand-deliver to the department

Air tube

Available 24/7 for Blood sciences and Microbiology samples.

Do not send Histology samples in the air tube

Air Tube

All sample containers must be properly closed and packaged in a dedicated sealed specimen bag with absorbent padding attached to the request form. Excessive numbers of samples should not be packed into a pod as this may cause the lid to open during transportation.

It is the responsibility of the sender to ensure that:

a. The sample is labelled, packed appropriately and is accompanied by the relevant paperwork.

b. The air tube sample carrier is secured properly before transport.

c. The air tube sample carrier is sent to the correct ‘system’ address

The sample(s) should be secured in the air tube carrier pod and the lid should be closed;

Instructions for sending samples from an external source

Specimens collected outside the hospital should be delivered using the correct packaging that complies with national guidelines and sent via hospital transport, courier or taxi. The department should be notified in advance of any urgent or special requests.

Frozen specimens from an external source

For specimens transported on dry ice, the sample should be sealed in a plastic specimen bag and the ice must be placed outside this bag. The package should be identified with a dry ice symbol.

Specimens transported on wet ice should be handled the same as above, but ensure that all packaging is leakproof.