Requesting pathology tests and sending samples

Request should be submitted on the associated laboratory’s request form. Laboratory requests must contain the following criteria to be accepted and processed:

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. Transfusion requests must contain the following criteria to be accepted and processed:

• Hospital registration number (P number) and/or NHS number
• Surname
• Forename
• Date of birth
• Clinical indications for the request (a telephone call can be made to discuss clinical indication)
• Signature from an authorised practitioner (this may be electronic for EPIC requests)

NB: PP requests are not acceptable.

The following information may be taken directly from the LIM system via the trust’s PAS interface, and is therefore not a mandatory requirement on the request form:

• Gender
• Location
• Consultant
• Medical Speciality
• NHS or Private Patient category
• Biohazard warning (if applicable)
• Indication of the urgency of the request

Any consent for examination testing or blood products should be confirmed as part of the specimen collection process. Specimens should be collected as per local processes, to ensure the safety of patients and service users, and labelled with three points of identification. Unlabelled and mislabelled specimens may not be accepted and could delay patient care.

Where multiple specimens are collected and submitted on the same request form, further differentiation should be added, for example:

• Site of collection (Histopathology)
• Time of collection (Dynamic Function Tests (DFTs))

Where the laboratory has specific requirements for specimen collection for examination tests these will be communicated via the laboratory’s user handbook.

Following collection, specimens should be handled with care and treated by all personnel as a potential infection risk. Specimens should be appropriately packaged, as detailed below, before sending to the laboratory with the request form affixed to the exterior of the packaging.

Low-Risk Diagnostic Specimens – Category B Biological Substances (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). Any tertiary container used to transport specimens around and between hospitals may vary in design but must comply with relevant standards such as IATA Packaging Instructions (PI 650).

High-Risk Infectious Specimens – Category A Biological Substances (UN2814)

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 readily identifiable. 

• “HIGH RISK” or “DANGER OF INFECTION” labels should be used for high risk specimens which are suspected of, or are known to contain, pathogens.
• 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.
• The specimen containers and pathology transport bags used for these specimens are identical to those used for low-risk specimens.

Specimens should be sent to the laboratory in a timely manner to ensure specimens remain suitable for use on receipt.

Birmingham Women’s Hospital

Method	Summary
Routine	On weekdays (excluding bank holidays) samples are collected from designated points by pathology staff.
Urgent	Hand-deliver to specimen reception for required laboratory
Air tube	Available 24/7 for limit specimen types – see below

 

Birmingham Children’s Hospital

Method	Summary
Routine	On Monday to Friday, samples are collected from designated points by pathology staff. On Weekends and Bank Holidays, samples are collected from ED and ITU only by pathology staff.
Urgent	Hand-deliver to the specimen reception for required laboratory
Air tube	Available 24/7 for limit specimen types – see below

Air Tube

The air tube is not suitable for use with all specimen types. The air tube should NOT be used for:

• High-risk specimens
• Blood products
• Blood culture bottles
• Blood gas specimens
• Histopathology /Cellular Pathology specimens

All specimen containers must be properly closed and packaged in a dedicated sealed specimen bag, with absorbent padding, and attached to the request form. The air tube sample carrier should be securely closed and sent to the correct system address for the required laboratory.

Excessive numbers of samples should not be packed into a pod as this may cause the lid to open during transportation, contaminating the air tube and causing downtime.

 

Specimens collected outside of our hospitals should be delivered using the relevant packaging (see previous) and sent via existing hospital transport, courier or taxi to the relevant laboratory.

The department should be notified in advance of any urgent or special requests.

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 labelled with a dry ice symbol.
• Wet ice - should be packaged the same as above, but ensure that all packaging is leakproof.