Queens Hospital Burton

1 Burton Hospitals NHS Trust File name: 01. Laboratory Handbook Pathology Laboratory Page 1 of 59. Controlled Document Do not copy Date of issue 24/12/2013. DOCUMENT TITLE Queens Hospital Burton on Trent Pathology Handbook DOCUMENT CODE Man/Handbook/Laboratory:01. EDITION No DATE OF ISSUE REVIEW INTERVAL Every 3 years AUTHORISED BY Mr P E Brassington AUTHOR Mrs A Hutchinson COPY 1. LOCATION OF Electronic COPIES. Document review history Review date Reviewed by Comments 1/3/10 Malcolm West Add section on CJD. (Microbiology CSF) Alter for changes in Staff and Structure. 24/12/2013 S. Maqsood Update of handbook 2/12/14 Malcolm West Update Histology with information on theatre samples. Pathology Handbook Burton Hospitals NHS Trust File name: 01. Laboratory Handbook Pathology Laboratory Page 2 of 59. Controlled Document Do not copy Date of issue 24/12/2013. Contents General information .. 5 Where to find us ..5 Consultant Advisory Quality Statement and standards ..5 Phlebotomy Receipt of Transport of Courier Service and Consumable/Supplies.

2 8 Request forms ..8 High Risk Turn-around times ..10 Results and Vacuette Selection Chart ..12 Haematology and Blood 13 Contact Routine Department On Call Haematology Receipt Of Specimens ..14 Transport of Request forms and specimen labelling..14 High Risk Thrombophilia protocol ..18 Blood Bank Sample requirements..18 Request form and Specimen labelling..20 Products ..20 Blood Clinical Chemistry Department .. 23 Contact Routine Department On Call Lipid/ Metabolic Clinic ..24 Receipt of Transport of specimens ..24 Request Forms ..24 Pathology Handbook Burton Hospitals NHS Trust File name: 01. Laboratory Handbook Pathology Laboratory Page 3 of 59. Controlled Document Do not copy Date of issue 24/12/2013. Specimen Labelling ..24 High Risk Minimum Sample Volumes Required For Paediatric Samples ..25 Sample Requirements..26 Listing Of Individual Dynamic Function Test Protocols Protocols for Investigation of Metabolic / Other Disorders ..37 Interpretation Of Paracetamol Levels After Overdose.

3 38 Guidelines For Screening For Hyperlipidaemias ..38 Guidelines For Treatment / Referral Of Hyperlipidaemia ..39 Functions Of The Lipid Clinic:..39 Microbiology Department .. 40 Contact Routine Department On Call Receipt Of Specimens ..41 Transport of Request forms and specimen labelling..41 Antibiotic Antibiotic Sensitivity Testing ..41 Antral Washings ..42 Blood Cultures ..42 Cerebrospinal Fluid (CSF) ..43 CJD .. 44 Chlamydia detection ..45 Chlamydia Specimen Collection Kit Male Urine .. 45 Female endocervical this kit can also be used for eye and rectal samples.. 46 Exudates and Eye Cultures ..47 Fungus Infections ..48 Gastric Genital Infections ..48 Hepatitis B ..49 HIV Nasal Pernasal Swabs (for diagnosis of whooping cough) ..50 Pregnancy Serological Tests ..50 Sputum ..51 Throat Swabs ..52 Tissues ..52 Urine ..52 Virus Pathology Handbook Burton Hospitals NHS Trust File name: 01. Laboratory Handbook Pathology Laboratory Page 4 of 59. Controlled Document Do not copy Date of issue 24/12/2013.

4 Histopathology Reception & Mortuary .. 55 Contact Routine Laboratory Service ..55 On Call Histology Reception service ..55 Mortuary Collection by Undertakers .. 55 Viewings .. 55 Release of bodies .. 55 Receipt Of Specimens ..55 Transport of Request form and specimen Frozen Fresh High Risk Formalin Supply and Usage ..57 Limbs for Histology (Orthopaedic) ..57 Sentinel Node Biopsy/ Radioactive breast tissue ..58 Immunology ..58 Non-Gynaecological Cytology ..59 Specimens for Semen analysis ..59 Pathology Handbook Burton Hospitals NHS Trust File name: 01. Laboratory Handbook Pathology Laboratory Page 5 of 59. Controlled Document Do not copy Date of issue 24/12/2013. Queens Hospital Burton Pathology Department General information Where to find us Queens Hospital Burton Belvedere Road Burton -on-Trent DE13 ORB. Telephone number of Hospital 01283 566333. Pathology enquiries 01283 566333 ext 3063/4048. General Laboratory Fax number 01283 593064. Consultant Advisory Service Burton Pathology currently has consultants available to give advice on appropriate investigations, investigation protocols, report interpretation and patient management.

5 Contact Numbers Consultant Haematologist Ext 5964. Consultant Haematologist Ext 4047. Clinical Specialist Haematology Ext 4894. Consultant Microbiologist Ext 4103. Consultant Chemical Pathologist Ext 4035. Quality Statement and standards We take every possible effort to ensure that accurate results are returned as quickly as possible to the correct source and we are continuously striving to improve our performance both in terms of accuracy and turnaround times. To maintain our standards and ensure highest quality of service, all departments take an active part in the relevant External Quality Assurance schemes and rigorous Internal Quality Control systems are also in place. If you have any problems regarding the quality of service you receive, please contact: Blood Sciences manager ( Burton Hospital , Ext. 4039). Routine Laboratory Service See each department for hours of routine service. On Call Service See each department for hours of on call service. Pathology Handbook Burton Hospitals NHS Trust File name: 01.

6 Laboratory Handbook Pathology Laboratory Page 6 of 59. Controlled Document Do not copy Date of issue 24/12/2013. Phlebotomy Service The Clinical chemistry/Haematology department at Queens Hospital provides a daily phlebotomy service within the Hospital for inpatients, outpatients and GP patients and on specific days outside the Hospital at five GP practices. A limited service is available on the wards on Saturdays, Sundays and Bank Holidays, to deal with URGENT requests only. See phlebotomy tube guide on Page 10. WEEKLY SCHEDULE. Monday Tuesday Wednesday Thursday Friday Saturday Sunday Phlebotomy Phlebotomy Phlebotomy Phlebotomy Phlebotomy Outpatients Outpatients Outpatients Outpatients Outpatients 0830-1700 0830-1700 0830-1700 0830-1700 0830-1700. Wards * Wards * Wards * Wards * Wards * Wards * Wards*. 0900-1200 0900-1200 0900-1200 0900-1200 0900-1200 0900- 0900- 1130 1130. Stapenhill Stapenhill Stapenhill Stapenhill Stapenhill 0815 1300 0830 1300 0830 1300 0830 1300 0830 - 1300. Yoxall Yoxall 0930 -1030 0930-1030.

7 Tutbury Northgate Tutbury 1030 -1130 1030 -1200 1030 -1130. Balance St Balance St Balance St Balance St 1230 -1330 1230 -1330 1230 -1330 1230 -1330. * Wards not covered are Maternity, Children's, Neo- natal, Intensive Care, High dependency Unit, and Acute assessment Unit. Pathology Handbook Burton Hospitals NHS Trust File name: 01. Laboratory Handbook Pathology Laboratory Page 7 of 59. Controlled Document Do not copy Date of issue 24/12/2013. Should a patient be unavailable to have their blood taken, or if the sample cannot be obtained, the phlebotomist will leave the unused labels in the designated pouch for the ward staff's attention, or write in the communications book if available. In the case of external GP/referrer, the form will be returned to the patient and request them to return to the referrer. Ward staff are requested to ensure phlebotomy labels are completed, have an intact bar code and are placed in the designated phlebotomy pouch in time for the phlebotomy round. Please be aware sample/test requests after this time may be declined by the phlebotomist as they are on a tight time schedule.

8 If you have any queries about phlebotomy services please contact: Blood Sciences Manager, Burton Hospital , 01283 511511 Ext. 4039. Receipt of Specimens During the hours between all routine specimens should be delivered to department via the pneumatic tube, where it is accessible. All other specimens should be delivered in the blue sealed containers to the Pathology Laboratory Reception and left in the relevant basket located at the hatch. Urgent specimens during working hours should be delivered by hand to the department, requesting urgency, or delivered by pneumatic tube and the department telephoned as to the urgency. --------------------------------- During hours for Haematology and Clinical chemistry ONLY. (see relevant dept for Microbiology) specimens should be delivered by pneumatic tube to the department, where it is accessible. Other specimens should be delivered in the blue sealed containers to the relevant basket located at the hatch in specimen reception and the relevant on-call pathology staff must be alerted via bleep if they are not in the laboratory.

9 Urgent specimens during should be delivered by hand to the department, requesting urgency, or delivered by pneumatic tube and the department telephoned as to the urgency. Please note Blood Gas samples should be delivered by hand with continuous agitation during transport, and to be handed to a Biomedical Scientist. ------------------------------------- During the hours between Only urgent specimens should be sent during this time. The relevant on-call pathology staff should be BLEEPED. when the specimen is sent. ALL specimens should be delivered by pneumatic tube to the department, where it is accessible. If delivered in the blue sealed containers to the relevant basket located at the hatch in specimen reception. Transport of Specimens All specimens should be placed in a plastic transport bag and sent via the pneumatic tube system, delivered by hand in a blue specimen container or a vacuum pod. Pathology Handbook Burton Hospitals NHS Trust File name: 01. Laboratory Handbook Pathology Laboratory Page 8 of 59.

10 Controlled Document Do not copy Date of issue 24/12/2013. Specimens from GP surgeries are collected and delivered by our courier drivers and these specimens must be packaged according the UN3373 regulations. Courier Service and Consumable/Supplies The couriers have designated courier runs in the morning and afternoon to GP. practices, Health Centres and local hospitals around Staffordshire, South Derbyshire and North West Leicestershire. Returning with the specimens at around 1300hrs, 1515hrs and 1800hrs when the specimens are separated and processed before any deterioration occurs. The couriers also: Distribute post from Queens Hospital postal department and pathology reports to the GP surgeries. Provide a service for Pharmacy to deliver Liquid Nitrogen to some surgeries and hospitals. Deliver consumables vacuette bottles and 24hr urine bottles to GP. surgeries. These must be ordered using the Pathology Consumables Order form which is available from the Pathology Laboratory on ext 3063.