The pre-analytical phase of the laboratory testing process is where the majority of laboratory errors occur. It is therefore vitally important that positive identification of the patient is established prior to sampling and that specimens are collected appropriately, adequately labelled and handled with due care and attention throughout. Clinicians are requested to follow approved clinical guidelines for the collection of specimens as summarised below and in the relevant sections. Additional advice available on techniques for venepuncture and a video has been prepared to provide information on the correct technique for the collection of blood cultures.
Sample Collection: Please ensure all Sterile Containers used for body fluids are"CE" marked leak proof container type.
|Nose swab||Prior to taking swabs from the nose, moisten with sterile saline. One swab should be rolled inside both nostrils.|
|Throat swab||One swab must be taken from the tonsillar area and/or posterior pharynx, avoiding the tongue and uvula.
The patient should stick out their tongue whilst the swab is guided down the side of the throat to make contact with the tonsil, a tongue depressor may be required.
|Perineal swab||One swab should be rolled over the area between the genitalia and the anus. Hygienic cleaning of the area should be undertaken, if required prior to swabbing.|
|Groin swab||One swab (moistened with sterile water) should be rolled along the area of skin on the inner part of the thighs closest to the genitalia.|
|Eye swabs||The exudate from the eye can be swabbed to identify some bacteria but others need to be identified by conjunctival scrapings which should be taken in an eye clinic.
If both eyes are to be swabbed a separate swab must be used for each eye.
|Wounds/ Skin lesions||One swab should be rolled over the area. The wound may be irrigated with saline to remove surface debris before taking the swab if remnants of dressing remain. Large wounds, rolls swab in a zig-zag motion to include all wound surface.|
|Catheter specimen of urine (CSU)||3-10mL urine required - All devices are needle-free Collect a specimen from the port using a syringe. Urine specimens must not be taken from the catheter bag as misleading results will be obtained owing to to bacteria having multiplied in the previously drained urine.|
|Mid-stream specimen of urine (MSU)||3-10mL urine required - the first few millilitres of urine should be discarded and the mid-stream specimen collected into a sterile container. The value of cleaning the perineum prior to taking the specimen is questionable.|
|24-hr Urine collections||
24 hour Urine Container - These are available from Pathology Reception during normal working hours.
Collection instructions: Early Morning Urine (EMU) is to be voided prior to commencing the 24hr collection. Extra caution should be taken when collecting and otherwise handling containers that carry acid preservative (refer to Patient instructions for 24-hour urine collection for further information).
|Stool/ Faecal specimens||15mL of liquid (or approximately the size of a walnut) is sufficient.
Stool specimens can be obtained from a bedpan containing urine, this does not affect results.
|High Vaginal Swabs||A vaginal speculum (sterile before use) must be used in order to separate the vaginal walls, using a strong light source the swab is taken from as high in the vagina as possible.|
If you take blood cultures, always read the instructions on the outside of the blue bags (adult) and the step-by-step poster guide Taking Blood cultures to make sure you are able to take blood cultures using the correct aseptic non-touch technique (ANTT).
For guidance on bottles being used please refer to Blood Culture Routine Set Adult or Blood Culture Paediatric If guidance on blood culture taking technique is required please check the Related links (lower left)
For procedures involving use of venous access devices to reduce the potential for contamination care must be taken to minimise interchange of samples at phlebotomy i.e. blood collected cross-contamination, care should by venepuncture as opposed to "needle-and syringe," whilst recommended guidelines are to be followed throughout.
|Blood (arterial)||To be taken using ABG syringes on the wards, the needle to be removed using needle rubber cap put on the syringe tip, the syringe placed in a specimen bag and transported to testing area. Please note: as requests are not made through EPR it is essential that all patient demographics are provided with the specimen and input at the point of analysis.|
|Indwelling devices||One swab to be rolled over the area of skin surrounding the device. Pre-moisten swab with sterile water|
|Pus||Pus may be collected using a sterile syringe and transferred into a sterile specimen container.|
|Cytology/ Histology tissue, organ or biopsy specimens||Tissues, sections and biopsies are to be transferred to designated containers. Extra caution should be taken when collecting and otherwise handling containers that carry formal saline/ methanol preservative.|
Patients and Clinicians are required to contact the Fertility centre directly to arrange specimen receipt by qualified scientists.
Please note: the Pathology laboratory does not process semen specimens for infertility.
All trust inpatient pathology results should be available on EPR. If results are not visible on EPR, please check Cyberlab.
All GP pathology results are available on Cyberlab, Results for GP requests made electronically via TQuest, are also available on the requesting GP system (EMIS).
Pathology results from sexual health clinic sources are available on the sexual health system (Preview).
Last updated: 27 November 2018