Form & Specimen Labelling

WebIce

When using the ICE system please ensure the labels on the sample bottles are put on length ways and straight otherwise the instruments cannot read them and the results will be delayed.

For more information on the correct procedure for labelling specimens please visit the ICE e-learning site and select ‘Labels’.

Errors

Studies have shown that up to 80% of laboratory errors occur in the pre-analytical phase. Such errors can have a detrimental effect on patient care. Users can significantly reduce the error rate by ensuring that all aspects of sample collection are carried out correctly.

Labelling

Essential Desirable
Sample
  • NHS,CHI or Health Care Number*
  • Patients full name or unique coded identifier
  • Date of birth and/or hospital number
  • Date and time
  • Nature of sample, including qualifying details, e.g. left distal etc. especially if more than one sample per requests is submitted
Request Form
  • NHS, CHI or Health and Care Number*
  • Patient’s full name or unique coded identifier
  • Date of Birth and/or hospital number
  • Gender
  • Patient’s location and destination for report
  • Patient’s consultant, GP or name of requesting practitioner
  • Investigation(s) required
  • Clinical information including relevant medication (which is sometimes essential)
  • Date and time sample collected (which is sometimes essential)
  • Patient’s address including postcode
  • Practitioner’s contact number (bleep or extension)

*Use of the NHS,CHI of Health and Care Number on paper and electronic patient records is a mandatory requirment included within the NHS Operating Framework 2008/9. Patient data should be used to identify the sample up to the point where an NHS or CHI Number is allocated whereupon this becomes the primary identifier.

Action regarding samples received with insufficient or incomplete minimum patient identification acceptance criteria

Samples or request forms received without the minimum essential identification criteria may be rejected without analysis or referred back to the requesting practitioner. The standard operating procedure MUST instruct laboratory staff NOT to amend details on the sample.

In cases where an inadequately labelled request form is received with a sample from a patient who is not easily accessible for a repeat then the sample may be processed at the discretion of the senior biomedical scientist in accordance with the local protocols. The report will show a clear disclaimer detailing the shortcomings of the sample and/or request and alerting the requesting practitioner to take responsibility for the results, and for any action taken as a result of the report.

A recent Biochemistry audit showed that in one month almost 400 samples were inadequately or incorrectly labelled. Samples that have been incorrectly labelled will be discarded.

Results

All results should be available on Path or ICE (except blood transfusion results) within 10 minutes of the results being authorised (please note the specimen turnaround times on the relevant department pages). Ensuring correct details are on the request forms and specimens will help to improve turnaround times.FormsA minimum of three patient identifiers are required but it is requested all fields are completed to ensure the highest data quality is maintained.The tests required should have the appropriate box ticked on the form. Please ensure that the correct boxes are used for requesting unlisted tests and for entering of clinical details.Please note:

  • It is essential all handwritten forms are legible.
  • It is essential that three patient identifiers are on both the sample and request form.
  • Failure to comply with the above points will result in either a delay in testing or possible rejection.
  • Please ensure the correct request form is used. Blank printable templates for histology and cytology requests can be obtained from the cellular pathology section of the site under ‘Request forms’.

Examples of how the request form should be completed

Combined request form (chemistry/haematology/immunology/coagulation)

Microbiology request form

Antenatal investigations

Antenatal booking bloods only

This form is for booking bloods only, with the expectation that other antenatal bloods will be ordered either via the ICE system or if no access to ICE on the smaller A5 white/purple antenatal investigation forms.The new requests have two bags attached (which were not a requirement of this trust but were for other trusts in the region).

We have suggested to the midwives that they use the bag attached to the rear of the request for the virology sample only as this gets coded within a separate laboratory (this may assist with samples going astray and being used for ferritin in the haematology lab). All other samples will be put into the bag on the front of the bag for central sort.