Specimen acceptance criteria

In order to minimise the potential for diagnostic delays and to otherwise ensure the veracity of results produced by our laboratories, the pathology department requests that clinicians familiarise themselves with the following general rules on sample acceptability...

 

General guidance

  • Addressograph labels are acceptable on request forms but must NOT be used on specimens as this hinders their processing within the laboratory.
  • EPR labels are an acceptable form of patient identification on specimens (NOT Blood Transfusion - see below) as they include the patient name or coded identifier, date of birth, gender, source location and hospital number.
  • Requests for group and/or cross-match must be in a special blood transfusion tube (red 7.5mL EDTA bottle) which is then clearly labelled by hand with all available patient identification (surname, first name, date of birth, hospital number.) 
  • See Blood Transfusion Request Form example Here 
  • PRE-PRINTED IDENTIFICATION LABELS MUST NOT BE USED for Blood Transfusion 
  • If the specimen and/or request form minimum criteria are not met then a specimen may be rejected.
  • The Pathology reception or laboratory staff may contact the requesting clinician if a correctly labelled specimen is received that is accompanied by a correctly labelled form that omits the requested tests – such specimens will be retained until the requesting physician is able to indicate which investigations are required.
  • Rejected specimens will be discarded into the pathology autoclave waste bins. The request will be logged on to the WinPath computer system and a comment entered detailing why the specimen has not been processed.

In addition to these general considerations, there are laboratory-specific sample acceptance criteria that must be met also - please see respective Biochemistry, Haematology and Microbiology-department guidance for full details.

Unlabelled specimens

Unlabelled specimens: specimens received into the laboratory will be rejected and discarded to clinical waste (exceptions may be made for “precious”specimens e.g. a biopsy or CSF specimen for which the provenance can be reasonably assured and the requesting is physician contacted who will assume full responsibility for any data derived from such specimens; - these will be referred to the relevant pathology clinical lead or senior BMS staff for individual consideration.)

Mismatched samples

Mismatched specimens: specimens that are received that include the name of one patient on the specimen and the name of another patient on the accompanying request form will be rejected.
 
If the laboratory is contacted by a ward/clinical area stating they have mislabelled a specimen, it will not be possible to return specimens for re-labelling as the integrity of the specimen cannot be guaranteed in such cases - a repeat specimen MUST instead be obtained and sent to pathology. Specimens with other information mismatches will be queried by reception staff and if necessary the ward will be contacted to determine the correct full identification of the patient.

Wrong specimen types

Specimens that are received in the wrong specimen container or the wrong specimen type for a given investigation will be rejected and a comment made on the laboratory information system. Please refer to advice on labile biochemical investigations or the Pathology test directory for specific sample requirements.

Mention should be made also of samples that have been received into the laboratory, for which following analysis there appears to be a strong suspicion that pre-analytical cross-contamination may have taken place. Clinicians are requested to ensure there is no interchange of samples at phlebotomy.

Ensure that the correct order of draw procedure is observed at all times.

Please refer to the S-Monovette Tube Guide

and Homerton Blood Tube Order of Draw Guidance

Leaking samples

Leaking or Unsafe specimens: these specimens will be discarded upon receipt. For specimens that are not repeatable (e.g. CSF, Histology or pre-treatment Microbiology specimens) all reasonable steps will be taken to decontaminate the outer surfaces of the specimen container and the specimen re-sealed for subsequent processing. A comment will be entered in the results on WinPath to indicate what has happened.