Patient Services Department Information

Patient Services Information (Laboratory Test Manual)

Phlebotomy Service

The laboratory provides a phlebotomy ward round between the hours of 7:30am and 12pm weekdays and a Weekend service as follows:

Saturday and Sunday:         7:30am - 11:30am

Request forms for this service should be completed prior to 7:30am, and placed on the appropriate clip in the ward office.

Any requests for blood tests received by the phlebotomist after the ward round has started will not be accepted unless the workload permits.  If the phlebotomist feels they are unable to complete the requested collects due to the remaining workload in the hospital they will decline the requests.  The requestor will be referred to the Pre-Analytics manager if discussion is required.  Blood collection after the ward round is finished is the responsibility of the medical officer initiating the request.

Ward round phlebotomists are trained for routine venepuncture.

They do not perform any collect from luers or lines.

Any request for a blood gas will be handed back to the clinical team as this collection requires specialised training.  The staff do not carry the required equipment and the time frame for processing the samples impacts upon the day’s workflow.

The week day phlebotomist can be contacted if required via the following pager number: 3085.

The Pre-Analytics HOD can be contacted on extension 2603 or 2452.

DHB Collection Sites

Mycology collections are only performed at the Wairoa and CHB sites.

Collection site staff do not perform swab collects.  They will advise people regarding self-collection procedures for screening requests.  All other collections should be performed by the Clinical team.

Laboratory Specimen & Request Form Acceptance Criteria

Specimens for Diagnostic Laboratory Testing except Transfusion Medicine

The specimen:

It is important to check that for the test(s) requested:

• The correct sample type has been selected (e.g.: additive/tube type)
• Sample containers/tubes are within expiry dates
• There is sufficient volume of sample
• Any transportation requirements are met (e.g.: temperature).

Ensure the tubes are mixed after collection to prevent clotting in those tubes with additives.

A list of collection guidelines and references is included at the bottom of this document.

Specimen labelling:

Minimum information on each specimen shall include:

• Surname and First name and Hospital number (NHI), OR
• Surname and First name and Date of Birth.

·           All laboratory specimens shall be labelled by the collector only after collection, and before        leaving the patient i.e.: in front of and witnessed by the patient.

Remember the final check:  SAY IT OUT LOUD

Read back the tube details to the patient for confirmation

·           In an emergency a unique patient identification number i.e.: Red Bracelet Number including        Hospital Number.

·           Where patient confidentiality is paramount a code may be used.  The nationally recognised        convention for coding of these specimens is as follows:

• First 2 letters of surname, first letter of first name, sex followed by DOB e.g.:       DOJM01021903 for John Doe 01/02/1903.
• ·Cord Blood Gas specimens to be labelled:
• "Baby of"
•  Mother's surname
•  Mother's first name
•  Baby's Hospital Number where available, otherwise Baby's date of birth.

If a multiple birth then also state “Twin 1 and Twin 2 etc.” on appropriate forms and specimens.

Request form:

The laboratory has five main types of request forms available:

• White              for routine laboratory test requests.
• Green              for “Add On” test requests in general ward areas.
• Pink                 for ED/AAU urgent test requests.
• Blue                 for ED/AAU “Add On” requests.

• Light Yellow     Histology and Cytology requests

Laboratory request forms shall contain the following information:

• Complete patient details including Surname, First name, DOB and NHI.
• Consultant/Specialty Team name.
• Location (e.g.: ED, AB1, and OPD).
• Encounter/Visit number (for hospital requests).
• Relevant clinical details.
• Name and signature of the person requesting the test(s).
• Name and signature of the person identifying the patient and sample(s).
• Time and date of specimen collection.

Bradma labels with up to date information are strongly recommended for all Laboratory request forms. The encounter number is required to direct results to the requestor's read list for sign off.

Refer to: Laboratory Sample Collection and Labelling Procedures HBDHB/CPG/120

Labelling Exceptions:

All samples with no labelling or mislabelling will be discarded unless a valid clinical reason can be provided to the Laboratory Manager or their delegate:

Samples from difficult to re-collect sites (e.g.: Histology samples, CSF’s, Blood Cultures collected prior to administration of antibiotics) meet this criteria.  Specimens not listed may be accepted at the discretion of the Laboratory Manager.

Inadequate Labelling of Samples and /or Request Forms Includes:

Partial labelling of sample or request

• Incorrect labelling of sample (e.g.: name spelt wrong or different date of birth on specimen to that of the form, but all other details match)
• Unlabelled request forms.

Acceptance will be on a case-by-case basis according to laboratory protocols.

Air Tube Delivery System

Hawke's Bay Hospital has a 15 station air tube delivery system.  The main clinical areas and the Laboratory are included in the network.  The reliability of the service depends upon the correct usage.  Please do not use the system if you have not been trained.  Errors in usage will shut down the system for a number of other users.  Refer to:

Lamson Tube System Policy HBDHB/OPM/098

Key contacts

• Pre-analytical Laboratory

Ph. 06 878 1308 ext. 2452

• Villa 8 - Phlebotomy Services Ext 2648

Monday - Friday 0800 - 1700

Pre-analytical HOD - Lynne Morgan Ext 2603

Links

HBDHB Laboratory Test Manual

Canterbury Health Lab Test Guide