- Whittington Health
- Version: 2021.1
- MB 129
Microbiology Department Print Date: 27 April 2021
Author: Service Managers Authorised by: DW
Page 1 of 189 Issue Date: 26 April 2021
PATHOLOGY USER GUIDE
Version 2021.1
Document Number : MB 129
Approved By: David Whittington
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The master document is controlled electronically. Printed copies of this document are not controlled. Document users are responsible for ensuring printed copies are valid prior to use.
- Whittington Health
- Version: 2021.1
- MB 129
Microbiology Department Print Date: 27 April 2021
Author: Service Managers Authorised by: DW
Page 2 of 189 Issue Date: 26 April 2021
CONTENTS
INTRODUCTION................................................................................................................................. 5 ADDRESS........................................................................................................................................... 5 LOCATION.......................................................................................................................................... 5 GENERAL ENQUIRIES ...................................................................................................................... 5 OPERATIONAL PATHOLOGY LABORATORY MANAGER............................................................... 6 SERVICE AVAILABILITY.................................................................................................................... 6 PHLEBOTOMY SERVICE................................................................................................................... 6 TESTS AND SAMPLES........................................................................................................................ 7 PERSONS MAKING REQUESTS....................................................................................................... 7 CONSENT........................................................................................................................................... 8 REQUEST FORMS............................................................................................................................. 8
General……………………………………………………………………………………………………..8
Completion of the Request Form.................................................................................................... 8
SAMPLE LABELLING ......................................................................................................................... 9
General……………………………………………………………………………………………………9
Blood Transfusion......................................................................................................................... 10
SPECIMEN TRANSPORT TO THE LABORATORY......................................................................... 10
Packaging and Sending Samples to the Laboratory .................................................................... 10 Ward and Clinic Collection Times................................................................................................. 10 Pneumatic Air Tube System ......................................................................................................... 11 Urgent Requests during Routine Working Hours ......................................................................... 12 Unstable Analytes......................................................................................................................... 12 Out-of Hours Specimen Transport................................................................................................ 12 GP Transport ................................................................................................................................ 12
RESULTS AVAILABILITY ................................................................................................................. 13 LABORATORY COMPUTER ............................................................................................................ 13 RESULTS INTERPRETATION ......................................................................................................... 13 REFERENCE RANGES.................................................................................................................... 14 MEASUREMENT UNCERTAINTY.................................................................................................... 14 DOWNTIME ...................................................................................................................................... 14 COMPLAINTS................................................................................................................................... 14
Complaints by Requesters of Tests.............................................................................................. 14 Complaints by Patients ................................................................................................................. 15
PATIENT CONFIDENTIALITY .......................................................................................................... 15
BIOCHEMISTRY............................................................................................................................... 16
TELEPHONE NUMBERS............................................................................................................. 16 ENQUIRIES and CLINICAL ADVICE ........................................................................................... 16 URGENT REQUESTS.................................................................................................................. 16 REFERRED TESTS...................................................................................................................... 16 ON-CALL SERVICE...................................................................................................................... 17 RESULTS ..................................................................................................................................... 17
ALERT / CRITICAL ACTION LIMITS ........................................................................................................ 17
TOXICOLOGY .............................................................................................................................. 18 THERAPEUTIC DRUGS .............................................................................................................. 19 CARDIAC MARKERS................................................................................................................... 19 LIVER FUNCTION TESTS ........................................................................................................... 19
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The master document is controlled electronically. Printed copies of this document are not controlled. Document users are responsible for ensuring printed copies are valid prior to use.
- Whittington Health
- Version: 2021.1
- MB 129
Microbiology Department Print Date: 27 April 2021
Author: Service Managers Authorised by: DW
Page 3 of 189 Issue Date: 26 April 2021
LIPIDS ……………………………………………………………………………………………………19
REJECTED REQUESTS.............................................................................................................. 19 BIOCHEMISTRY TIME LIMITS FOR REQUESTING ADDITIONAL TESTS ............................... 20 ARTEFACTS................................................................................................................................. 22 FORMULAE.................................................................................................................................. 23 BIOCHEMISTRY TEST GUIDE.................................................................................................... 23 BIOCHEMISTRY DEPARTMENT REFERENCE LABORATORIES............................................ 47
HAEMATOLOGY .............................................................................................................................. 48
TELEPHONE NUMBERS............................................................................................................. 48 URGENT REQUESTS.................................................................................................................. 48 ON-CALL SERVICE...................................................................................................................... 48 RESULTS ..................................................................................................................................... 49 HAEMOGLOBINOPATHY SERVICE ........................................................................................... 49 TOP TEN HAEMATOLOGICAL INVESTIGATIONS .................................................................... 49 HAEMATOLOGY TIME LIMITS FOR REQUESTING ADD ON TESTS ...................................... 52 FACTORS THAT CAN AFFECT SAMPLE INTEGRITY............................................................... 53 HAEMATOLOGY TEST GUIDE ................................................................................................... 53 TEST REPERTOIRE .................................................................................................................... 54 REFERRAL TESTS ...................................................................................................................... 61
BLOOD TRANSFUSION................................................................................................................... 63
SPECIMEN REQUIREMENTS..................................................................................................... 63 IMPROVING THE SAFETY OF BLOOD TRANSFUSION: ABO CONFIRMATORY TESTING... 63 TEST REPERTOIRE .................................................................................................................... 64 TURNAROUND TIMES ................................................................................................................ 67 REFERRAL TESTS ...................................................................................................................... 68
MICROBIOLOGY.................................................................................................................................. 69
INTRODUCTION............................................................................................................................... 69 LABORATORY HOURS.................................................................................................................... 69 AVAILABILITY OF CLINICAL ADVICE ............................................................................................. 69 ON-CALL SERVICE.......................................................................................................................... 69 TELEPHONE NUMBERS.................................................................................................................. 70 USE OF THE LABORATORY............................................................................................................ 70
Requesting.................................................................................................................................... 70 Requesting Additional Tests......................................................................................................... 71 Specimen Containers ................................................................................................................. 72
TURNAROUND TIMES..................................................................................................................... 73 BACTERIOLOGY.............................................................................................................................. 73
GENERAL REPORTING GUIDELINES ....................................................................................... 73 1. 2. 2.4 2.5 3.
Urinary Tract Investigation............................................................................................... 74 Gastrointestinal Disease Investigation ............................................................................ 77 Specimen collection for Helicobacter Antigen testing ..................................................... 79 Specimen collection for Norovirus Investigation.............................................................. 80 Sterile Body Fluid Investigation ....................................................................................... 80
Investigation ................................................................................................................... 83
Abscess ....................................................................................................................................... 83
……………………………………………………………………………………………………83 ……………………………………………………………………………………………………84
Throat swabs.................................................................................................................. 84 MRSA SCREENING INVESTIGATION........................................................................... 84 Miscellaneous investigation............................................................................................. 85 Blood Culture Investigation.............................................................................................. 86 Respiratory Sample Investigation.................................................................................... 89 Skin, Hair and Nails Investigation for Dermatophyte....................................................... 93
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The master document is controlled electronically. Printed copies of this document are not controlled. Document users are responsible for ensuring printed copies are valid prior to use.
- Whittington Health
- Version: 2021.1
- MB 129
Microbiology Department Print Date: 27 April 2021
Author: Service Managers Authorised by: DW
Page 4 of 189 Issue Date: 26 April 2021
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- INVESTIGATION OF GENITAL INFECTIONS................................................................ 94
SEMEN ANALYSIS......................................................................................................... 97
VIRAL ISOLATION ........................................................................................................................... 99 SEROLOGY/IMMUNOLOGY.......................................................................................................... 100 TAKING THE SAMPLE......................................................................................................................... 129
THERAPEUTIC DRUG MONITORING.......................................................... 139
TELEPHONE NUMBERS................................................................................................................ 140 GENERAL INFORMATION............................................................................................................. 140 HISTOPATHOLOGY INVESTIGATIONS........................................................................................ 141
Sending the specimen ................................................................................................................ 141 Availability of formalin containers ............................................................................................... 141 Request Forms ........................................................................................................................... 141 When will the result be available? .............................................................................................. 141 Urgent reports........................................................................................................................... 142 Frozen sections........................................................................................................................... 142 Factors known to affect the interpretation of histology specimens............................................. 142 How do I get histology results?................................................................................................... 143 POST-MORTEM EXAMINATIONS ............................................................................................ 143
CYTOLOGY INVESTIGATIONS..................................................................................................... 143
DIAGNOSTIC (NON-GYNAE) CYTOLOGY............................................................................... 144
