Guidance on specimen collection
A properly collected specimen is critical to quality test results. Ensure that:
- The correct specimen type is collected.
- The correct amount is collected.
- The specimen is collected in the right container with any necessary additives.
- The specimens are collected following safe working practices.
- Ensure that there is no contamination from external sources when collecting microbiology and virology samples.
- Clean surgical instruments and surgical trays must be used when collecting Histopathology samples.
- The container is securely sealed and labelled.
- Place the labelled specimen container in a plastic specimen mini-grip bag which is available on the Wards, in the Clinics and from central stores and seal.
- Each specimen bag must only contain samples from one patient (DO NOT mix patient samples).
- For ease of sample processing in the laboratory it is advisable to place each discipline sample in a separate sample bag for the same patient.
- Place the matching requisition in the outside pouch of the bag.
- Always send the specimen promptly to the laboratory or the collection point.
Each specimen container:
- Must be labelled at the time of collection i.e. next to the patient when the sample is taken and not prior to, or remotely from the patient after collection.
Note: Never label the specimen bag.
Note: The Laboratory (apart from Cellular Pathology) will discard a specimen if it is received unlabelled.
- Must be labelled with the correct bar-code label (pre-printed label with accession numbers generated by an information system) except Blood Transfusion samples which must be labelled by hand.
- Must have a label whose information matches the information on the accompanying request form.
Note: Specimens will not be accepted if the information does not match. Cellular Pathology will liaise with the referring clinician to update details.
- Must have no more than one label placed on it.
- Must not have the request form wrapped around it as a specimen label. This is not acceptable.
A label that does not contain the required information or which has illegible information will be considered to be improperly identified and will result in delays or a decision not to process the specimen. In these instances, a repeat specimen will be requested. Cellular Pathology will liaise with the referring clinician to update details.
Note: Always label the specimen clearly with the name, hospital number, date of birth and collection date and time.
Royal Free London users: CERNER
CERNER labels can be placed on all specimens except for Blood Transfusion samples.
Blood Transfusion samples
- Collect and label samples from one patient at a time.
- Check the identity details on the patient wristband matches the identity details on the request form.
- The samples must be labelled by hand.
- Do not label the samples with CERNER generated barcode or addressograph labels.
- Label the sample at the patient’s bedside using information from the patient’s wristband. Write the patient’s full name, date of birth, hospital number. Where the patient is able to communicate they should be asked their full name and date of birth to confirm details are correct.
- Write the date and time of collection, and signature of the person who took the blood.
- Phlebotomists covering wards need to ask a second person to check patient details written on the sample before the sample is sent to the laboratory.
Blood samples for all other disciplines
- Place the CERNER label along the length of the tube, as straight and as far up as possible without touching the cap of the tube, so that the analysers can read the label.
- It is imperative that the label quality is checked prior to labelling the specimen bottles as poor quality barcodes cause delays and introduce risk of errors in the laboratory.
- Ensure the correct label goes on the corresponding tube. Requests for Clinical Biochemistry tests must be attached to the appropriate tube
- In addition write the date and time of collection on the label. If the date and time of collection is not recorded the sample may be rejected by the laboratory.
Cellular Pathology (Histopathology and Cytopathology) specimens, urine, stool, CSF, amniotic fluid specimens and respiratory specimens (Microbiology & Virology)
- Place the CERNER barcode label along the length of the container. This is to enable bar code reading.
- It is imperative that the label quality is checked prior to labelling the specimen bottles as poor quality barcodes cause delays and introduce risk of errors in the laboratory. Please see section 18.104.22.168 below for correct attachment of labels to the specimen bottle
Note: CERNER labels must NOT cover the barcodes on the blood culture bottles as these need to be read by the analyser
The minimum information required on the specimen label is three unique identifiers that MUST match the information on the request form. These should be:
- Patient name (Surname/family name and first name)
- Hospital number (or Private Patient number) and / or date of birth NHS number (if available)
In addition, specimens should be hand-labelled with the date, and time if appropriate, of collection. Please note it is a mandatory requirement to label the specimen with the date and time of collection.