Each test request received and accepted by Homerton Pathology laboratories is considered to be an agreement between the requester and the pathology laboratory. Therefore the requester must specify the information required by the pathology laboratory on the request to ensure that appropriate examination and result interpretation is provided.
In accordance with International standard requirements Homerton Pathology Laboratories requires the name of the person taking each specimen to be provided on the form(s) accompanying the specimens.This information should be provided for all T Quest and manual/paper form requests.
Patient identification - It is the responsibility of the practitioner (e.g. phlebotomist, Health care support worker (HCSW), Nurse or Doctor) performing the specimen collection to positively identify the patient before performing the procedure. See Specific guidance in the Trust Patient Identification Policy. Patients must be positively identified before blood specimen is taken (by checking patient’s wrist band where appropriate or with demographics stated by the patient -see Homerton Trust Identification of Patient policy on the Homerton intranet).
It is the responsibility of the clinician to ensure that the patient meets the laboratory patient preparation requirements.
Each specimen must be collected in the correct specimen container. If you do not have details or are unsure of which container to use, please refer to
Please ensure that sufficient blood is taken (fill sarstedt bottle to fill line) so that specimen is not adversely affected by any additives (e.g. a blood specimen may be under or over citrated if the correct volume is not provided, and the specimen may be rejected as a result).
The collection of all specimen types will be in line with Trust policy on specimen collection. Where there is no clearly defined Homerton procedure users are advised to follow the practices as outlined in the Royal Marsden manual of Clinical Nursing procedures. Staff competencies and training requirements with regards to collecting such specimens will be determined locally by relevant line managers and/or supervisory staff.
The practitioner performing specimen collection will be responsible for ensuring there is satisfactory lighting, ventilation, privacy and positioning of the patient prior to commencing any procedure. Phlebotomy managers (out-patients) or senior nursing staff (in-patients) must ensure satisfactory facilities are available and clearly signed so the safe and confidential collection of all phlebotomy and/or specimen collection is guaranteed.
Phlebotomy Stage & correct Blood Volume in Specimen Tubes
Samples with insufficient volumes of blood can result in operational errors. This can lead to potential cross contamination of samples and may give rise to erroneous results.
At the phlebotomy stage we also would like to request all samples especially clotted samples e.g: Virology, to be thoroughly mixed (inverted 6-7 times) to enable proper clotting.
It is the responsibility of the practitioner performing the specimen collection to fully and accurately label all specimens.
Never label specimens away from the patient – specimens must be labelled at the patients’ side.
Never pre label any specimen bottle or container – specimens must be labelled immediately after collection, whilst with the patient.
Minimum acceptable criteria for all specimens received in Pathology
All specimens must be labelled with at least three of the following:-
i.Patient’s Surname (and Forename where possible)
ii.Hospital Number, NHS Number or other unique identifier number
iii.Date of Birth
Please provide the date and time of collection of a sample on each sample and any forms submitted for testing.
Please ensure that patients are aware of this requirement if they will be providing a self taken sample.
If the above information is not present on the specimen then Pathology may reject the specimen and request a repeat be taken.
- It is the responsibility of the requesting practitioner completing the request form or specimen label to ensure that sufficient information is provided and is correct. The laboratory cannot make assumptions about the origins or nature of specimens or the accuracy of any given details.
- If the information provided is inadequate to safely process the request then delays may occur or the request may be rejected/ returned to the sender. Every effort will be made to ensure that specimens are processed correctly and that vital specimens are not discarded, but if the integrity of the information provided or the source of a specimen is in doubt it will be destroyed.
Ordering via Cerner EPR
All hospital patient requests, both inpatient and outpatient should be made via the EPR system (see EPR Training manuals available on the Trust intranet for instructions on how to order tests via EPR.) If EPR is not available please refer to the contingency procedures for EPR system failure...
Create order, print label/s, take it to the patient, collect specimen required, fix correct label to each specimen(Each test label MUST be attached to the correct specimen required for each pathology request - Click here to find out about which specimen types are required for which test across Pathology Departments for guidance.)
All EPR specimens must be appropriately labelled with: -
i. Patient’s Surname and Forename (or unique identifier)
ii. Hospital Number or NHS Number (if known)
iii. Date of Birth
iv. Date and time of specimen collection
Only one EPR label should be affixed to each specimen container which will specify on it the type of bottle/ container needed for a given investigation in addition to any further instruction necessary should the specimen require any special processing i.e. “Rush to lab!,” “Protect from light!” etc.
Please note: The number of labels produced indicates the number of specimens to be collected.
Particular care should be taken with non-blood specimens to ensure the correct label is attached to the correct specimen type.
Please ensure all patient orders made via EPR are received into the laboratory within one week of generating an order as these requests will be otherwise “auto-closed” on the Pathology laboratory system.
Ordering via Request form
Hard copy request forms may be used by General Practitioners, Health Care Centres and other pathology users external to the Trust.
Emergency Manual Pathology Request Forms may also be used in the event of EPR system failure (available here.)
It is essential that the request form is correctly completed with sufficient information to allow for correct identification of the patient and source of the request and clinical information (when applicable) to ensure appropriate interpretation and timely reporting of results. If the request form is completed by hand, it is essential it is legible to those processing the request(s).
The following information must be completed on the request form (i.e. minimum acceptance criteria for request form): -
i. Patient’s Surname and Forename
ii. Date of Birth (not age)
iii. Hospital Number, NHS Number or other unique identifier number
iv. Tests required
v. Sender’s address or location
vi. Name of requesting clinician
vii. Date and time of specimen collection
viii. Sex of patient
ix. Relevant medical history
x. Current or significant therapy
xi. Specimen source e.g. wound/drainage site,
xii. Specimen type
xiii. Patient’s contact details (Address/ telephone number where available)
Ordering via Indigo4 tQuest
Generally, the same requirements as are necessary for ordering pathology requests via the Trusts EPR system should be observed when making patient orders using the community-based Order Communications system: tQuest.
For advice on how to use tQuest please click here.
Blood transfusion specimen
Blood transfusion specimens must be hand written. Date/ time of sampling and the signature of the practitioner drawing the specimen MUST be appended to both specimen AND request form. For Blood Transfusion specimen requirements please refer to: Sample and request form labelling.
Correct specimen tube labelling
The correct alignment of barcode labels on specimen tubes is vital for the timely availability of results. Please ensure the labels are attached correctly on the specimen bottle.
- The long side of the label should run vertically down the specimen and as straight as possible; - these need to be as close to vertical as possible so that the various pathology analysers can read the barcode.
- Please put patient labels over the existing bottle sticker so that the contents remain partially visible.
- DO NOT attach more than one specimen label at a time, the number of labels printed should correspond with the number of tubes drawn (if there are extra labels these should be enclosed with the accompanying specimen bag and sent alongside the specimen(s.)
- All trust inpatient pathology results should be available on EPR. If results are not visible on EPR, please check Cyberlab.
- Pathology results from GP requests are available on Cyberlab.
- Pathology results from sexual health clinic sources are available on the sexual health system (Preview).
External Pathology Results
For many GP practises, health care centres and other external service users results are transmitted electronically on a daily basis. Where not available then printed reports are returned timely to the requesting clinical user.