S02 Attachment Ten 10 Specimen Collection.pdf

CBOC Specimen Collection Follow detailed patient identification and specimen collection / phlebotomy procedures as provided in Lab-Gen-Pol#113- 023 Pathology & Laboratory Medicine Service Reference Manual, pages 12-16 (provided as Attachment Lab003) CBOC Specimen Processing The following is an overview of specimen processing required by CBOC staff. Detailed procedures are supplied to CBOC staff for collection, processing and packaging specimens for transport.

1. All PST and SST tubes (noted with * on attachment Lab001) are to be centrifuged at the CBOC prior to transport to VAMC. Centrifugation must occur between 20 minutes and 2 hours post collection for optimal specimen preservation.

Centrifugation must be performed in a horizontal (swinging head) centrifuge, with speed/rotor sufficient to achieve 1100 RCF, to achieve sufficient specimen separation (approximately 8-10 minutes). All other blood specimens are submitted without centrifugation.

2. In the case of 3 or less patients’ specimens to be sent the specimens may be submitted in bags as follows: All blood specimens as well as vacutainer urine specimens for a single patient are to be in one zippered biohazard bag with an accompanying requisition in the outer pouch. The need to submit paper requisition is eliminated if all order numbers for which testing is desired are present on the specimen containers. If more than three patients’ specimens are sent, the rack packaging instructions must be used.

3. Urine specimens (in cups) for each patient are submitted in a separate zippered biohazard bag with an accompanying requisition in the outer pouch. The need to submit paper requisition is eliminated if all order numbers for which testing is desired are present on the specimen containers. Cytology requisitions must be submitted in the paper form.

4. Additional specimen processing (separation/freezing of plasma) may be needed for specialized testing and this is communicated to the CBOC staff as needed.

CBOC Rack Packaging Instructions:

1. After collection of specimens for a patient, place a patient label in CBOC transport log, noting the specific rack number on the log and matching the specific row number with the row number (1-24) that the blood specimens are placed in rack. Ensure that if there are multiple order numbers for a patient, that all are included on the label with the preprinted order number either circled or highlighted as well to make sure no orders are missed.

2. Place all blood specimens and tubes of urine in the row that corresponds to the row number on the log. If there are more than three blood /urine specimens for a single patient, use two rows and mark this on the transport log.

3. Specimens that require centrifugation are removed from rack for centrifugation and returned to same row after centrifugation. It is critical to verify that specimens are returned to the correct row.

4. Each rack holds a maximum of 24 different patient’s specimens. The patient specimen will be in the same order in the rack as on the accompanying CBOC transport log, a notation of position for each patient is noted on the transport log.

5. Urine specimens for UA and culture can be sent in the tube only. If a tox screen is ordered the cup must also be sent.

6. Other specimens such as urine specimens in cups, stool cards, or other larger liquid specimens for each patient are place individually in a separate zippered biohazard bag (with an accompanying requisition in the outer pouch if applicable).

7. The need to submit paper requisition is eliminated as all order numbers for which testing is desired must be written on the transport log and the specimen containers. Cytology requisitions must be submitted in the paper form.

8. To pack specimen in transport cooler: Place each rack into a large biohazard bag designed to hold a rack or multiple specimens.

9. Place all other bagged specimens for the same transport time in a separate large biohazard bag.

10. Place each rack in the bottom of the cooler to retain in upright position and place the bagged specimens on top of beside the racked specimens. All urine specimens in cups will now be in two bags to prevent leakage into cooler.

11. Check the transport log to verify that the rack number for each sheet is filled in, put packager initials, and the date and time packaged on the top sheet, staple all sheets for a single delivery together, and hand to courier.

See Sample Manifest on following pages.

ATTACHMENT TEN (10) - SPECIMEN COLLECTION

36C24821R0092

_____________ CBOC Transport Log – Rack System – Page 1

Date: Shipment: AM PM (Circle) Packed by:_________________

Time packed:______________________

Transported by: _________________ Received by: ______________________

Time of Receipt: _________________

Rack #_____(Side 1) Overall Condition on Receipt: ________

If Problems – what staff member at CBOC was notified: _____________________

Position

Place label or hand write Patient Identifier in column below - Write number of each specimen type for the patient in column below each type. Write specimen type if other is used (red, stool) green gold lavender

M arble blue urine other

Position

Place label or hand write Patient Identifier in column below - Write number of each specimen type for the patient in column below each type. Write specimen type if other is used (red, stool) green gold lavender

M arble

B lue

U rine

O ther

Position #1

Place Label here

Position #7

Place Label here Position #2 Place Label here

Position #8 Place Label here Position #3

Place Label here

Position #9

Place Label here Position #4

Place Label here

Position #10

Place Label here Position #5

Place Label here

Position #11 Place Label here

Position #6 Place Label here

Position #12

Place Label here