All requests for microbiology investigations must be made by, or on behalf of, a registered medical practitioner, a recognised nurse practitioner or similar, to whom the results will be sent.
Requests signed by an authorised person (for example a practice nurse) on behalf of a practitioner are acceptable as long as the origin is stated clearly, and the request is fully completed.
Where possible, requests should be made using the electronic WebICE system. This limits errors in patient identification and speeds up workflow in the laboratory.
When making a request please ensure that all the relevant patient identification, clinical details and locations are provided, including the name of the requesting physician.
Requests for urgent tests must be made to the laboratory by telephone prior to sending the sample to the laboratory. This includes:
- Paediatric and neonatal urine samples for cell count
- CSF samples
- CAPD samples
- Prosthetic joints for cell count
- Ascitic fluids for cell count
- Fluids for urgent Gram’s stain
All specimen containers must be clearly labelled with a self-adhesive sticker or handwritten information and must include:
- The patient’s full name
- Date of birth, and/or hospital number
- Site of sampling
The information on the specimen must directly link with the information on the request form.
Please ensure that all specimen containers are filled with the correct/adequate volume of sample.
For most routine laboratory procedures, consent can be inferred when the patient presents himself/herself at a laboratory, or other suitable primary or secondary care setting, with a request form and willingly submits to the usual collecting procedure.
If any additional requests are required after the specimen has been sent, please call the laboratory within 2 days and send a request form for the additional tests requested. The additional laboratory request form must be received in the laboratory prior to the test being carried out.
Test request requirements
A request form must accompany all specimens sent to the laboratory. Each test must have its own request form and sample. If multiple samples are being sent, each must have its own associated form. All Request forms must clearly state the following information:
- Patient’s full name (initials or nick names will not be accepted)
- Patient’s address
- Date of birth
- NHS number or hospital number
- Patient gender
- GP practice code – which will be where the result is returned
- Ward location for inpatient specimens
- Name of requesting clinician
- Type of specimen
- Relevant clinical details – including:
- Site of specimen
- Presenting symptoms
- Any foreign travel – this is prompted by WebICE
- Recent or current antibiotic use
- Pre-existing conditions; diabetes/Bronchiectasis/COPD
- If the sample is a repeat
- Immunosuppression status of the patient
- Date of sampling
- Time of sampling
- Risk status (see high risk specimens)
- Any relevant epidemiological information
- Any antibiotics that the patient is taking
A lack of clinical information may result in investigations being missed or organisms being unreported. Please ensure clinical information is present, detailed and relevant. It is the responsibility of the requesting person to ensure that request forms are filled out with the adequate information. Failure to do so may result in rejection of the specimen.
High risk specimens
Medical officers responsible for the care of patients have a duty of care towards other members of staff. Any specimens that are known, or suspected, to be high risk must be clearly labelled with a danger of infection sticker.
All specimens from patients who are known to have or strongly suspected of having the conditions listed below must be identified by adding a Danger of Infection label to the specimen container and the laboratory request form:
- Hepatitis B and C
- Viral haemorrhagic fever (VHF) of any type
- Microorganisms, (biological agents) in Hazard Group 3 or 4
- TB, Brucella sp., Salmonella typhi/paratyphi, Transmissible Spongiform Encephalopathy (TSE)
- Pyrexia of unknown origin (PUO) recently returned from Africa.
Clinicians should ensure that appropriate information including relevant travel history is provided in order to alert laboratory staff to potential dangers. Clinical details supplied on specimen request forms must contain clear information regarding the nature of the test being requested and sufficient detail to inform laboratory staff upon the safety precautions they need to take in order to process the specimen without risk of infection.
If, during patient intervention, further information becomes available that has implications for the safety of laboratory staff this must be communicated immediately to the laboratory so that appropriate steps regarding containment can be taken.
Instruction for transporting samples
Within the trust samples are to be transported according to trust policy HIC28.
Transport for infectious substances by Royal Mail is subject to carriage of dangerous goods regulations 2004 and requires transport and packaging conforming to P650 Packaging.
Patients are able to carry their own specimens via their own or public transport.