This manual is intended to give an overall view of the services available in the department of laboratory medicine. Individual tests available and test guidelines can be viewed on the Active Test Repertoire table. referred maybe viewed on the Referred Test Repertoire Table Ref: LF-GEN-0066-71 Active Test Table and LF-GEN-0072 Referred Test Table Blood Tube Guides are available on Q-Pulse, the hospital intranet and in clinical areas. QUAILTY IMPROVEMENT IN 2017: Syndrome Tests Suggestions Notes Suspected FBC, U+E, LFTs PET bloods should only routinely be sent in women with hypertension (systolic BP ≥140mmHg or diastolic BP ≥90mmHg on more than 2 separate measurements which are ideally 4 hours apart) after 20 weeks gestation. Proteinuria on dipstick is defined as ≥+2 protein. Trace protein does not count towards the diagnosis Daily PET bloods are not required apart from in exceptional circumstances on request from senior obstetrician NICE guideline 107. Will need to clarify with the hospital PET guidelines Confirmed FBC, U+E, LFTs For mild hypertension (140/90mmHg to 149/99mmHg) send bloods twice weekly during regular hours (8am-6pm) For moderate and severe hypertension (≥150/100mmHg) send bloods every second day during regular hours After birth, repeat PET bloods at 48-72 hours during regular hours (8am-6pm) and if normal there is no need to repeat again NICE guideline 107. Will need to clarify with the hospital PET guidelines Hb post Hb check At first this should be done with a haemacue on the ward. A formal FBC should only be sent if the level is approaching the need for a transfusion Intrapartum fever U+E, LFTs, CRP tests are not routinely required for an intrapartum fever work up which is done just for an isolated pyrexia with no other systemic signs of sepsis. Hospital intrapartum guideline section
EMERGENCY CONTACT FOR THE LAB STAFF ON CALL: BLEEP 538 ON CALL MOBILE 086-2626101 ON CALL BEDROOM Ext 1482 Position Name Contact no. / Bleep Director of Laboratory Services Dr Richard Drew 1466 Laboratory Manager Mr. John O’Loughlin 1762 Consultant Histopathologist Dr. Deirdre Devaney 1358 Consultant Microbiologist Dr. Richard Drew 1466 Consultant Andrologist Dr Edgar Mocanu 1466 Consultant Chemical Pathologist Dr. Ingrid Borovickova 1345 Consultant Histopathologist Dr. Emma Doyle 6868 Consultant Histopathologist Dr. Eibhlis O Donovan 6834 Consultant Haematologist Dr. Melanie Cotter (Paediatric) Dr. Fionnuala Ni Ainle (Adult) Contact Reception. 1459 or Reception. Laboratory Office Enquiries Jacinta Core 1739 Laboratory Porter Gerry Price 1739 Biochemistry/Endocrinology Grainne Kelleher 1345/1701 Blood Transfusion/Haematology Deirdre Murphy 1463/1464 Microbiology /Serology Dave Le Blanc 1466/1210 Histopathology Colma Barnes 1467 Mortuary Bill O’Neill 1442 Infectious Diseases Liaison Midwife Mairead Lawless Bleep 883 Infection Control ADOM Marian Brennan Bleep 518 Infection Control Midwife Alva Fitzgibbon Bleep 522 Haemovigilance Officer Siobhan Enright 6803 Bleep 725 Quality Manager Deputy Quality Manager Susan Luke Emily Forde 6872 1464/1463 Health & Safety Officer Deputy Health & Safety Officer Aiveen O’Malley Michael Smith 1345 1467 Training Co-ordinator Deputy Training Co-ordinator Ciaran Mooney Niamh Cahill 1464/6837 1466 of Care Co-ordinator Laboratory IT Manager Deputy IT Manager Deputy Point of Care each Department involved in Point of Care Lorna Pentony John O’Loughlin Phil Bateson Responsibilities rest with the Chief Medical Scientist in each department responsible for item of equipment. 1345 1762 1467 See departmental contact numbers
Placenta Request Form The placenta order details should be completed on the electronic order and the request form should be printed from the electronic chart in all cases in which a placenta is submitted for examination and histology. Requirements with respect to completing the request and to labelling specimen must be followed; a non-conformance will result from the following reasons: Specimen Issues Action Documentation No specimen received Specimen not identified Specimen unlabelled Addressograph on specimen in case of BT Mandatory identifiers must be on specimen A second specimen must be collected or specimen taker must take responsibility in cases of an emergency or where the specimen cannot be repeated. If tested the report will reflect the Exceptions are CSF, blood cultures and histology specimens where samples cannot be repeated. Allow sample taker to correct error. If specimen is processed LF-GEN-0013 Specimen Request Amendment Form is completed. A non-conformance may be raised. Request/Forms Issues Action Documentation Inadequate or incorrect patient details. Incorrect/No test requested Ordering physician not identified Specimen collected at incorrect time or date or A second specimen is requested if the requester or clinical staff looking after the patient does not correct error. If specimen is processed. Specimen Request Amendment Form is completed. A non-conformance may be raised.
time of collection not indicated. Specimen / Quality Issues Action Documentation Evidence of Haemolysis Gross lipemia Presence of clots Age of specimen The laboratory will decide on whether the specimen is suitable for the requested test. A repeat sample will be requested as appropriate. If tested the report will show the non-conformance. Not Applicable Where specimens from MNCMS are not labelled appropriately, e.g. barcodes not straight on bottle, incorrect test on incorrect sample type, a delay will occur in processing sample or the specimen may be rejected. Where barcode ID band is not scanned for Blood Transfusion samples, this sample is not suitable for crossmatching and a repeat will be required.
Criteria for Specimen Rejection than Labelling Discrepancies) Department Insufficient Specimen Clotted Incorrect Specimen Type Age of Specimen Incorrect Leaking Inappropriate Test Request Haematology ● ● ● ●FBC>2hrs Blood films >8hrs* ● ● ● Coagulation ● ● ● ● ●>4hrs ● ● ● Blood Transfusion ● ● ● ● > 24 hrs at RT ● ● ● Biochemistry ● ● ● ● ●>24hrs ● ● ● Endocrinology ● ● ● ● ● ● ● Microbiology ● ● ● ● Urines>24hrs Semen for Infertility >2hrs Post Vasectomy Samples >3 days Viral Load >24hrs ● ● ● Virology serology ● ● ● ● ● ● ● Histology N/A N/A N/A N/A N/A N/A N/A N/A Cytology N/A N/A N/A N/A N/A N/A N/A N/A *Specimens must be kept refrigerated. These are the most common reasons for specimen rejection. It is not possible to document every probable situation. However if the medical scientist considers that the specimen quality will adversely affect the test result the specimen will be rejected. Histology laboratory does not reject any specimens. Microbiology and Biochemistry will not reject CSF samples.