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ST. JOSEPH MEDICAL CENTER LABORATORY SERVICES

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1. HPV screening detection can also be performed on the liquid based pap smear vial Surepath RESPIRATORY SYNCYTIAL VIRUS ANTIGEN DETECTION l Collect up to 2 0 ml of nasal secretions or a nasopharyngeal washing into a sterile dry screw top container To perform a nasopharyngeal washing instill no more than 1 0 ml of sterile water into each nostril using a plastic disposable premature infant feeding tube attached to a 10 ml syringe or a suction catheter with a mucous trap Aspirate secretions following installation Transfer no more than 2 0 ml to Chlamydia Viral transport media Specimens are referred according to the following schedule a Monday through Friday 7 30 a m 4 00 p m except holidays b ALL OTHER TIMES Deliver specimen to STAT LAB ROTAVIRUS ANTIGEN DETECTION Collect 5 0 grams of soft or liquid stool into a sterile dry screw top container and freeze SPECIMENS SUBMITTED AS DIAPERS ARE NOT ACCEPTABLE CHLAMYDIA CULTURES 1 The Serology laboratory provides Chlamydia Viral Transport Media and Dacron swabs which must be used for collection and transport of ALL Chlamydia Culture specimens Store transport media in refrigerator until use Deliver specimen to the Laboratory immediately after collection 2 DO NOT use calcium alginate or wooden shafted swabs for collection of specimens utilize dacron rayon or cotton swabs with plastic or metal shafts 3 Refer to the following chart for specific source of spe
2. anal canal Move swab from side to side to sample crypts Withdraw swab If fecal contamination occurs discard swab and obtain another specimen Place swab into chlamydia transport and break off tip Recap tightly Place specimen on ice and deliver immediately to Serology Remove specimen from ice and place in freezer Conjunctival swab Apply topical proparacaine based anesthetic to eye Using a small swab thoroughly swab inner surface of the lower then upper eyelid If samples are taken from both eyes use swab on less affected eye first to avoid further contamination of that eye Place swab into chlamydia transport media and break off tip Recap tightly Place specimen on ice and deliver immediately to Serology Remove specimen from ice and place in freezer 4 The following specimen types are not satisfactory for Chlamydia culture Discharges urine and urinary sediments fluids from the pouch of Douglas throat swabs swab or oropharynx and sputum 5 Chlamydia GC testing can be performed on the liquid based pap smear vial Surepath RAPID IDENTIFICATION OF CHLAMYDIA TRACHOMATIC ANTIGEN CHLAMYDIA GC DNA PROBE ASSAY 1 Specimen should be collected into special GEN PROBE transport depending on the source of the sample There are separate collectors for endocervical swabs and urethral swabs No other collectors may be used Obtain appropriate collector from the Specimen Processing area of the Laboratory 2 The only
3. approved specimen types are endocervical and urethral swabs Urines are not acceptable for testing 3 Maintain specimen at 2 4 C for transport 4 False positive results have been reported if specimen contains blood or powder from the examination gloves LEGIONELLA CULTURE 1 The following specimens may be submitted for Legionella culture and or DNA PROBE lung tissue biopsy pleural fluid transtracheal aspirate bronchial washing endo and naso tracheal secretions sputum and induced sputum 2 Specimens should be collected into a sterile dry container with secure screw top and kept refrigerated T 123 ADMINISTRATION LABORATOR Y LABORATORY MANUAL Current service manual files St Joseph Center Laboratory Services Updated 8 07 doc 16 LEGIONELLA URINARY ANTIGEN Collect 5 ml of a clean caught first voided urine into a sterile dry container with a secure screw top Store refrigerated LEGIONELLA DIRECT FLUORESCENT ANTIBODY STAIN DFA Refer to LEGIONELLA CULTURE for specimen collection protocol MYCOPLASMA CULTURES GENITAL MYCOPLASMA CULTURES Mycoplasma hominis Ureplasma 1 Specimens from the genital area may be cultured for Mycoplasma hominis and or Ureaplasma urealyticum by obtaining the specimen with a sterile swab Mix contents of swab into vial containing Mycoplasma transport Blue Capped M 4 Microtest Media and discard swab Transport is stored in refrigerator in Serology Laboratory 2 After collection store spec
4. name line by the second person assisting in the patient identification and sample labeling 4 The sample label is initialed using Meditech mnemonics of the actual phlebotomist The blood sample and requisition are sent immediately to the Blood Bank 6 A qualified Blood Bank technologist will confirm that all identifying information Patient Name Unit Number and Date of Birth on the request form agrees with that on the specimen tube label Any sample received by the Blood Bank found to have a discrepancy or incomplete incorrect includes spelling illegible or missing information is to be discarded and a new sample requested Date of collection may be added after the collection if missing from the label 7 If signatures are missing from the slip or tube the sample is to be discarded and a new sample drawn 8 A specimen label may not be altered removed or replaced in any way If incorrect the sample will be discarded A specimen label or original identification cannot be covered or over labeled in any way If there is evidence of over labeling the sample will be discarded and a new draw requested by the Blood Bank a T 123 ADMINISTRATION LABORATOR Y LABORATORY MANUAL Current service manual files St Joseph Center Laboratory Services Updated 8 07 doc MICROBIOLOGY Specimens must be properly labeled and received in sterile containers in order to be processed Minimum information necessary is patient name identification number D
5. AL Current service manual files St Joseph Center Laboratory Services Updated 8 07 doc Phone 410 494 6421 Fax 410 494 6432 Monday Friday 7 30 a m 4 00 p m 4 Osler Medical Building 7600 Osler Drive Room 103 Towson Maryland 21204 Phone 410 337 1784 Fax 410 427 2331 Monday Friday 7 30 a m 4 00 p m 5 Office Building A 7501 Osler Drive Towson Maryland 21204 To be opened December 2007 4 Core Laboratory a Chemistry Hematology and Coagulation 1 Open 24 hours daily for the processing and testing of specimens needing emergency attention 2 Processes all routine specimens as received Some tests are performed on a scheduled basis Monday Friday or Tuesday and Thursday only Call the laboratory on extension 1308 for details 3 Routine bone marrow studies are scheduled through the Cytology Laboratory along with a Pathologist for patients as ordered by the physician 5 Microbiology 1 Open daily from 7 00 a m 9 30 p m for routine and emergency testing 2 Stat requests after these times should be delivered to the Core Laboratory 6 Blood Bank a The Blood Bank is open all days all shifts for routine and emergency testing b Blood Bank personnel issue blood and blood products throughout the hospital and track its usage in accordance to regulatory and accrediting standards 7 Histopathology a Open from 8 00 a m until 4 30 p m Monday through Friday and from 8 00 a m 12 00 Noon on
6. Head Supervisor Lead Technologists HISTOLOGY Section Head Supervisor LAB INFORMATION SERVICES Coordinator MICROBIOLOGY Section Head Supervisor Lead Technologist PHLEBOTOMY Section Head Supervisor POINT OF CARE Section Head Coordinator Kay Buchanan Ph D MT ASCP Lucia A France Steven Axe M D Marene Paul MS MT ASCP Jeanette Clayton MT ASCP Michael J Dugan MT Fowzia Taqi M D Paula Wilder BS HTL CM ASCP Jason Smith MS C ASCP David A Brinker M D Jessica Reinhardt MT CLS M NCA Betty Chin MT Kay Buchanan Ph D MT ASCP Angela D Dodson Dr Zhen Fan M D Eileen Farrish MS MT ASCP SATELLITE LABORATORIES and OUTREACH SERVICES Section Head Supervisor SEROLOGY Section Head Supervisor SPECIMEN REFERRAL Section Head Supervisor SURGICAL PATHOLOGY Section Head Secretarial Supervisor Kay Buchanan Ph D MT ASCP Lucia A France Steven Axe M D Jessica Reinhardt MT CLS M NCA Kay Buchanan Ph D MT ASCP Lucia A France James W Eagan Jr M D Sandra Moran T 123 ADMINISTRATION LABORATOR Y LABORATORY MANUAL Current service manual files St Joseph Center Laboratory Services Updated 8 07 doc SPECIMEN LABELING REQUIREMENTS GENERAL Orders placed via the hospital computer system will generate specimen labels containing appropriate information The specimen container type is stated on the label as well as specia
7. Room 206 7401 Osler Drive Towson Maryland 21204 Telephone Fax 410 494 6446 410 494 6445 Office Hours Monday Friday 7 30 a m 4 00 p m St Joseph Medical Center Medical Laboratory Osler Medical Building Room 103 7600 Osler Drive Telephone 410 337 1784 Towson Maryland 21204 Fax 410 427 2331 Office Hours Monday Friday 7 30 a m 4 00 p m St Joseph Medical Center Medical Laboratory O Dea Medical Arts Building Suite 504 7505 Osler Drive Telephone 410 337 1763 Towson Maryland 21204 Fax 410 337 4520 Office Hours Monday Friday 7 30 a m 5 00 p m St Joseph Medical Center Medical Laboratory Professional Centre Suite 106 120 Sister Pierre Drive Telephone 410 494 6421 Towson Maryland 21204 Fax 410 494 6432 Office Hours Monday Friday 7 30 a m 4 00 p m OUTREACH SERVICES Phlebotomy and testing services are provided to the following groups 1 Masonic Home of Maryland 2 Presbyterian Home 3 Edenwald Retirement Community 4 Villa Assumpta Villa Maria Nursing Home 5 6 Maples Assisted Living 7 Holly Hill Nursing Home 8 Morningside House of Satyr Hill T 123 ADMINISTRATION LABORATOR Y LABORATORY MANUAL Current service manual files St Joseph Center Laboratory Services Updated 8 07 doc Brightview Retirement Communities White Marsh amp Mays Chapel Ridge SCOPE OF SERVICES DEPARTMENT OF PATHOLOGY LABORATORY I Description The Laboratory provides both inpatien
8. ST JOSEPH MEDICAL CENTER LABORATORY SERVICES LOCATION Clinical Laboratory Hospital Ground Floor Anatomic Pathology Ambulatory Services Building Second Floor Morgue Autopsy Suite Hospital 2 Floor near Physical Medicine entrance HOURS Routine Work 8 00 a m to 4 30 p m seven days per week Exceptions Histopathology closed Sundays Flow Serology Cytopathology closed Saturdays and Sundays STAT Work Around the clock seven days per week INFORMATION SCHEDULING Blood Bank Clinical Laboratories all sections Cytopathology Pathologists Surgical Autopsy Pathology STAFF Medical Director Administrative Director Laboratory Manager Associate Pathologists BLOOD BANK Section Head Supervisor CHEMISTRY URINALYSIS Section Head Supervisor Lead Technologist CYTOPATHOLOGY Section Head Supervisor FLOW CYTOMETRY Section Head 410 337 1746 410 337 1710 410 337 1735 410 337 1717 410 337 1717 James W Eagan Jr M D Kay Buchanan Ph D MT ASCP Christian Rizo MBA HTL ASCP Steven Axe M D Fowzia Taqi M D David A Brinker M D Zhen Fan M D Fowzia Taqi M D Nancy Stec MA MT ASCP SBB Steven Axe M D Marene Paul MS MT ASCP Jeanette Clayton MT ASCP Michael J Dugan MT Sharon Barr MT ASCP Fowzia Taqi M D Jean Wright BS CT ASCP Louise Kirby CT ASCP Steven J Axe M D FRONT DESK Section Head Supervisor HEMATOLOGY Section
9. Saturday b A pathologist is available on call at all times and may be reached by contacting the laboratory at 410 337 1710 c Tissue specimens for frozen section studies maybe scheduled in advance between 7 00 a m 6 00 p m 8 Cytopathology a Open from 8 00 a m until 4 30 p m Monday through Friday to complete diagnostic studies b Specimens obtained at all other times are delivered to the Clinical Laboratory s Stat Laboratory 9 Phlebotomy Area a Phlebotomists are on staff daily from 6 00 a m 12 00 a m b Phlebotomy personnel perform venipunctures Arterial Blood Gas and capillary collection procurement on outpatients and inpatients as scheduled for diagnostic testing 10 Immunology and Flow Cytometry Laboratories a Open from 7 30 a m 4 30 p m Monday through Friday b Specimens for testing may be collected at any time but are not always analyzed on a daily basis T 123 ADMINISTRATION LABORATOR Y LABORATORY MANUAL Current service manual files St Joseph Center Laboratory Services Updated 8 07 doc C The requester may contact the Send Out department Monday through Friday 7 00 am 5 00 pm or the laboratory 1739 at other times to determine specific requirements and estimated completion times for studies 11 Morgue and Autopsy Suite a Location The Morgue and Autopsy Suite are located on the Second Floor of the Main Hospital down the corridor to the right of the Freight Elevators as you
10. cimen SPECIMEN SOURCE COLLECTION PROCEDURE Cervical swab Clean endocervix with a swab amp discard or use for a GC culture Insert another swab into the endocervix and rotate with sufficient pressure to obtain columnar epithelial cells Place swab tip into Chlamydia transport media and break off Cap transport media tightly and place in cup of ice Deliver to Serology immediately Remove specimen from ice and place into freezer Urethral swab Patient should not have urinated one hour prior to collection Insert swab at least 2 cm into urethra Rotate swab to obtain epithelial cells Mix swab in chlamydia transport and break off Recap tightly and place on ice Deliver immediately to Serology Remove specimen from ice and place in freezer T 123 ADMINISTRATION LABORATOR Y LABORATORY MANUAL Current service manual files St Joseph Center Laboratory Services Updated 8 07 doc 15 Nasal Pharyngeal swab Collect swab and place into Chlamydia transport media breaking off tip of swab Recap tightly and place on ice Deliver immediately to Serology Remove specimen from ice and place in freezer Respiratory aspirate Collect aspirate from nose nasopharynx or oropharynx by using a disposable premature infant feeding tube attached to a 10 ml syringe Place aspirate into chlamydia transport and recap tightly Place specimen on ice and deliver to Serology immediately Remove from ice and place in freezer Rectal swab Insert swab 3 cm into
11. d by the Medical Executive Committee 4 Proper utilization of STAT services is encouraged to enable better service for true emergency situations 4 Collection and Delivery of Specimens a Laboratory Personnel Responsibilities From 6 00 a m 12 00 a m 1 Blood specimens for routine and Stat diagnostic testing are obtained by laboratory personnel in the Med Surg Floors 3E 3W 4E 4W 5E 5W 6E 6W 7E and on 2North 1 West 2 Any blood specimens collected by laboratory personnel are either hand delivered to the laboratory or sent via the pneumatic tube system 3 Requests are made through the MT system which interacts with the Phlebotomy Hand Held Device b Nursing Personnel Responsibilities 1 Certified nursing personnel in the MSICU CSU ED PEX 3E 3W PACU PAT L amp D MTC DDC and NICU may perform venipunctures on outpatients and or inpatients scheduled for diagnostic testing of blood 2 Certified nursing personnel are responsible for performing venipunctures on patients scheduled for diagnostic testing of blood between 12 Midnight and 6 00 a m 3 Nursing personnel are responsible for the collection and delivery of all specimens urine blood feces body fluids as ordered by the physician and according to procedures outlined in the laboratory manuals located on the hospital intranet 5 Result Reporting a Laboratory results are available through the Meditech Patient Care Information PCI Module which
12. ds collection tube Eye Conjunctival Press swab against the inflamed Red capped M 4 Microtest swab area of the conjunctiva Media viral chlamydia tube Tissue or Biopsy Collected by physician Red capped M 4 Microtest Media viral chlamydia tube available from hospital storeroom DO NOT PLACE in formalin or other preservative Blood Collect in early acute stage of illness CONTACT SEROLOGY LABORATORY Limited availability test MUST BE SCHEDULED 5 ml minimum AFTER COLLECTION DO NOT FREEZE SPECIMENS NOTE ALL SPECIMENS FOR VIRAL CULTURE SHOULD BE STORED AT 2 4 C T 123 ADMINISTRATION LABORATOR Y LABORATORY MANUAL Current service manual files St Joseph Center Laboratory Services Updated 8 07 doc 14 OTHER SPECIAL VIRAL AGENT COLLECTIONS AND PROCESSING HUMAN PAPILLOMAVIRUS SCREEN TYPING 1 4 Specimens obtained by swab for the cervix or urethra or tissue biopsy must be collected into a special VIRA PAP collection kit Detailed instructions for collection are included with the kit No other collection container is acceptable Kits are available at the Specimen Referral area of the Laboratory Specimens are stored at 2 4 C until and during transport Swab specimens may be held over for up to 7 days Tissue biopsy specimens MUST BE SUBMITTED to the reference laboratory within 24 hours of collection Therefore test is available Monday through Friday 7 30 a m 4 00 p m except holidays
13. e gently inverted 7 10 times to prevent clot formation The amount of anticoagulant it contains will prevent a filled tube from clotting with proper mixing If the tube is less than half filled the proportion of anticoagulant to blood may be altered enough to give unreliable laboratory test results Green Top tube This tube contains lithium heparin as the anti coagulant After the tube has been filled it should be inverted 7 10 times to prevent clot formation Use this tube when preparing heparinized plasma specimens Light Blue Top tube This tube contains 0 5 ml of a 3 8 solution of sodium citrate as the anticoagulant Blood drawn in this tube is used specifically for prothrombin times partial thromboplastin times and other coagulation procedures It is essential that 4 5 ml of blood is obtained in this tube The vacuum in the tube is calibrated to draw that amount After the tube is filled it should be inverted 7 10 times to prevent clot formation This tube must be allowed to fill to its capacity An improper blood coagulant ratio will invalidate coagulation test results Yellow Mustard tube This tube contains a gel and clot activator to promote clotting and to allow for separation of cells from serum after centrifugation Bright Yellow tube This tube contains an ACD anticoagulant Solution B liquid activator to prevent clotting T 123 ADMINISTRATION LABORATOR Y LABORATORY MANUAL Current service manual files St Joseph Center Labora
14. enables the user to view and or print patient results b Critical results are telephoned to patient areas or health care provider to insure proper notification c Outpatient results are delivered to providers by fax mail or courier based on customer preference IIL Communication Mechanism Problem Resolution Nursing personnel with questions regarding the clinical and or technical aspects of diagnostic testing may contact the appropriate laboratory department Chemistry Hematology Coagulation Microbiology etc for clarification Nursing personnel with problems and or concerns related to operation and or employee concerns may contact the Administrative Director regarding same T 123 ADMINISTRATION LABORATOR Y LABORATORY MANUAL Current service manual files St Joseph Center Laboratory Services Updated 8 07 doc 10 SPECIMEN COLLECTION AND PREPARATION The quality of test results reported by any laboratory is directly dependent upon the proper collection and handling of the specimens submitted Patient and specimen identification correct specimen s for test s requested specimen collection and preparation for transport as well as holding temperature are essential to a clinically meaningful test result The following is designed to assist you in providing the quality specimens essential to patient service BLOOD COLLECTION TUBES Generally speaking 40 of whole blood is retrieved as either serum or plasma Therefore from the avera
15. face them Personnel transporting deceased patients to the morgue must contact Escort Services 1234 between the hours of 7 00 am to midnight From midnight to 7 00 am contact Security A key may also be obtained from the Core Laboratory s Stat Laboratory It is the responsibility of Medical Records personnel to notify the laboratory of patients for autopsy Refer to Governing Rules Section VIII Death Standards for Post Mortem Care Reporting amp Disposition of the Body Death Certificates Eye Donation Organ Donation B Methodology for Diagnostic Testing 1 In Patient Patients may be scheduled for diagnostic testing as follows Meditech Order Entry System a Authorized personnel may utilize the Meditech Enter Orders option to schedule Out Patients and or Blood Bank In Patients for Chemistry Hematology Coagulation and Immunology Microbiology and Cytological diagnostic studies This routine prompts the user to select the patient Laboratory category Laboratory vs Micro diagnostic study priority date and time study is to be collected and method of collection Laboratory or Nurse Draw Additional prompts such as specimen type and comments are required based on the nature of the order Blood Bank orders produce a printed requisition which must be signed by the individual obtaining the sample and a second signature by a witness to the identification of the patient Laboratory Requisitions must be utilized When Histopa
16. ge patient a completely filled 10 ml tube will give about 4 ml of serum or plasma 1 Red Top plain tube This tube contains no preservative or anticoagulant and is used for collecting a clotted blood specimen This is the tube of choice for therapeutic drug levels when serum is specified as the sample After drawing the specimen typically is allowed to clot at room temperature for 30 45 minutes The specimen is centrifuged and the serum portion is transferred into a properly labeled transfer vial in the laboratory prolonged exposure of the serum to the clot will invalidate many test results Dark Blue Top tube Contains sodium heparin anticoagulant This tube is especially treated for use in determination of trace elements such as zinc selenium etc Gray Top tube This tube contains oxalate as an anticoagulant and fluoride as a glucose preservative After the tube is filled it should be gently inverted 7 10 times to prevent clot formation The fluoride glucose preservative will maintain the glucose level in the blood for several hours Brown Top tube This tube contains heparin as an anticoagulant and should be mixed 7 10 times after drawing It is a specially treated tube for the determination of blood lead levels Lavender Top tube This tube contains liquid EDTA ethylenediamine tetra acetic acid anticoagulant which is present in the appropriate concentration for most hematologic procedures After the tube is filled it should b
17. imen in refrigerator RESPIRATORY MYCOPLASMA CULTURES Mycoplasma pneumoniae Mycoplasma hominis 1 Place swab of specimen or transfer at least 0 2 ml of specimen into a vial of Mycoplasmia transport Blue Capped M 4 Microtest Media Transport media is stored in refrigerator in Serology Laboratory 2 After collection store specimen in refrigerator for transport NOTE Specimen must reach reference laboratory within 72 hours of collection DO NOT FREEZE SPECIMENS Reviewed by Kay Buchanan Ph D MT ASCP Date Administrative Director Lab Services T 123 ADMINISTRATION LABORATOR Y LABORATORY MANUAL Current service manual files St Joseph Center Laboratory Services Updated 8 07 doc
18. itted in a pre weighed lightly sealed container provided by the laboratory When requesting a 24 48 or 72 hour collection the use of this container is essential T 123 ADMINISTRATION LABORATOR Y LABORATORY MANUAL Current service manual files St Joseph Center Laboratory Services Updated 8 07 doc ROUTINE VIRAL CULTURE COLLECTION 13 COLLECTION SPECIMEN PROCEDURE CONTAINER VOLUME Throat swab Swab posterior pharynx Bartels Flex Tran inflamed or erythematous areas viral chlamydia tube or visible lesions Throat washing Have patient rinse mouth Sterile sputum cup 10 ml thoroughly with 10cc sterile distilled water expectorate and discard Administer a second 10cc volume of sterile distilled water have patient deep gargle and expectorate into sterile screw top sputum cup Sputum Instruct patient to produce Sterile sputum cup sputum in response to deep cough and expectorate into sterile sputum cup Feces Collect a fresh stool specimen Sterile screw top jar 3 6 grams Rectal swab Insert sterile swab 3 5cm into Red capped M 4 Microtest rectum and rotate to collect fecal Media viral chlamydia material tube Urine Collect a clean caught first Sterile screw top jar 10 20 ml morning urine Dermal Genital Collect vesicle fluid by scraping Red capped M 4 Microtest lesion the base of the lesion or by Media viral chlamydia aspiration tube CSF or other body Collected by physician Sterile screw top 1 2 ml flui
19. l handling instructions e g PLACE ON ICE The label MUST be placed on the correct container and positioned lengthwise with the flat end die cut up to the stopper or cap safety skirt All labels that are printed for a set of orders MUST be sent to the Laboratory even if there are more labels than containers PATIENT IDENTIFICATION The patient s name and date of birth must be confirmed to match that on the labels before any specimens are collected to assure proper patient identification BLOOD BANK PATIENT IDENTIFICATION FOR CLINICAL CARE AND TREATMENT In all cases patient identification and specimen labeling is to be done at the side of the patient Patient identification is to be done simultaneously reading aloud by two persons who have been trained to the hospital patient identification policy Both persons will then sign the Blood Bank request 1 A computer label addressograph label or hand printed label may be used The information must be legible correct includes spelling and complete see 2 Any discrepancies from this will result in a re draw being requested by the Blood Bank 2 The patient s wristband specimen label and request are compared aloud for Patient First and Last Name if a middle name or initial is used they must agree Date of Birth Patient Unit Number Date of Collection 3 The request slip is signed by the actual phlebotomist in the indicated space and co signed validation of
20. oagulated specimens e Storing in a refrigerator that is too cold f Freezing and thawing a specimen 2 Lipemia Describes specimens that are cloudy or milky due to the presence of excessive amounts of fat In some instances if samples are taken too soon after the patient has eaten lipemic specimens may result Lipemia will affect a number of test results There are some clinical 11 situations that present with lipemia as part of the expected findings For these specimens and where an overnight fast was not possible prior to phlebotomy the laboratory is equipped with an ultracentrifuge to clear the sera provided that an adequate sample is obtained This centrifuge provides enough force to separate the fat particles leaving clear serum to be used for testing T 123 ADMINISTRATION LABORATOR Y LABORATORY MANUAL Current service manual files St Joseph Center Laboratory Services Updated 8 07 doc 3 12 Quality Not Sufficient QNS This is the laboratory s way of saying there was not enough specimen to perform the test s requested We are very aware that the specimen s we receive are many times all that can be obtained from the patient Every effort is made to handle and test these specimens carefully and accurately Please refer to specific sections of this manual for individual test volume requirements URINE CONTAINERS 1 Non sterile 120 ml This container is used for random and 2 hour urine collections The container ha
21. octor ordering culture or room number date of collection and specimen type Sterile containers and transport media are available from purchasing Improperly labeled or unlabeled specimens are unacceptable for culture The only exceptions will be for those specimens requiring an invasive procedure or instrumentation for collection In these instances the proper label must be brought down and verified in person by the nurse or physician All changes must be initialed Specimens must be sent in tightly sealed containers with no external spillage Leaking contaminated containers are a hazard to personnel and will not be accepted If a container becomes contaminated during collection wipe off with disinfectant before transporting to the laboratory Disinfect specimen containers from isolation units with disinfectant and place in appropriate bag for transportation Keep specimen containers upright TOXICOLOGY THERAPEUTIC DRUG SPECIMENS All tubes must have the following legible information on the label Patient s first and last name Room Number Location Date Collection Time Time of last dosage if therapeutic drug monitoring specimen Sot gala Salar T 123 ADMINISTRATION LABORATOR Y LABORATORY MANUAL Current service manual files St Joseph Center Laboratory Services Updated 8 07 doc ST JOSEPH MEDICAL CENTER OUTPATIENT LABORATORY COLLECTION CENTERS St Joseph Medical Center Medical Laboratory St Joseph Professional Building
22. s no preservative and is unsatisfactory for cultures This urine container is also used for drug abuse screening general drug screening other miscellaneous toxicology tests performed on urine and cytological evaluations For cultures see Midstream Urine Collection Kit below After the specimen is collected it is essential to secure the container Please tighten the container lid to prevent leakage during transport Midstream urine collection kit This container includes materials necessary to properly collect sterile midstream urine for culture and routine urinalysis The gray stopped vacutainer tube is for culture and the urine specimen is stable for 48 hours at room temperature 24 hour urine container 2000 ml This container is to be used for all 24 hour and timed 12 hour urine specimens and is obtained from the laboratory Because of the length of time required to collect a 24 hour specimen many tests require a preservative to be added to the container prior to collection Naturally different tests require different preservatives Some may be collected without preservative MISCELLANEOUS CONTAINERS 1 Biopsy Histology contains 10 buffered formalin The biopsy specimen should be placed into the formalin solution immediately Note that specimens in this fixative may not be used for any microbiology testing Various size containers are available Measured stool collection a stool sample for quantitative tests must be subm
23. t and outpatient testing for both common and special laboratory tests Additional specialized testing is performed in laboratories approved by the Medical Executive Committee Il Location A Location 1 Main Hospital a Ground Floor 1 The Core Laboratory which includes the Stat Chemistry and Hematology Coagulation Laboratories 2 The Blood Bank 3 Microbiology 4 Front Desk Reception Area a The Staff process outpatients for diagnostic testing and the distribution of laboratory results to inpatient and outpatient locations b Hours of Operation Monday Friday from 8 00 a m 8 00 p m Saturday from 8 00 a m 4 30 p m Sunday from 9 00 a m 2 00 p m b Second Floor 1 The Morgue and Autopsy Suite 2 Ambulatory Building Second Floor Anatomical Laboratories a Surgical Pathology b Histopathology c Cytopathology d Pathology Offices e Immunology and Flow Cytometry 3 Satellite Laboratories Locations and Hours of Operation a Hospital Campus 1 O Dea Medical Arts Building 7505 Osler Drive Suite 504 Towson Maryland 21204 Phone 410 337 1763 Fax 410 337 4520 Monday Friday 7 00 a m 5 00 p m 2 St Joseph Professional Building 7401 Osler Drive Room 206 Towson Maryland 21204 Phone 410 494 6446 Fax 410 494 6445 Monday Friday 7 30 a m 4 00 p m 3 The Professional Centre 120 Sr Pierre Drive Suite 106 Towson Maryland 21204 T 123 ADMINISTRATION LABORATOR Y LABORATORY MANU
24. thology diagnostic testing is ordered by the physician In areas without access to the Meditech Order Entry System When a special Down Time Requisition is used in the event of a computer down time planned or unexpected 2 Out Patient a b Patients can be registered through the Meditech Hospital Registration System at all Satellite Laboratories and the Front Desk Reception Area of the Main Hospital Patients must have written orders with them or they can be faxed to the laboratory before diagnostic testing can occur 3 Classification of Diagnostic Testing Clinical Laboratory a Routine Testing Diagnostic testing classified as routine is usually ordered during the hours of 8 00 a m and 6 00 p m and are completed within 4 hours after receipt of the specimen in the laboratory Routine chemistry and hematology coagulation tests will continue to be processed throughout the evening as received daily T 123 ADMINISTRATION LABORATOR Y LABORATORY MANUAL Current service manual files St Joseph Center Laboratory Services Updated 8 07 doc c STAT Testing 1 Diagnostic testing classified as STAT is of an emergent nature and must be ordered as such by the physician 2 STAT specimens are processed in the STAT Laboratory twenty four hours a day with an average turn around time for completion of less than one hour from receipt of sample in the laboratory 3 STAT tests are defined by the Department of Pathology and approve
25. tory Services Updated 8 07 doc GENERAL SUMMARY OF VACUUM BLOOD COLLECTION TUBE INFORMATION Stopper Color Anticoagulants Main Uses Light Blue Citrate liquid Coagulation Brown lead free Heparin Blood lead Dark Blue Sodium Heparin Zinc amp various heavy metals Gray Fluoride oxalate Toxicology amp Glucose Green Heparin sodium or lithium Special studies Lavender EDTA liquid Hematology amp Immunology Dark yellow serum separator None Chemistry Red None Chemistry Therapeutic Drug Levels Blood Bank amp Immunology Bright Yellow sterile ACD Body fluids culture When the laboratory tests require multiple types of tubes the following order of draw is recommended Blood Culture No Additive Light Blue Top SST Speckled Serum Separator Mustard Yellow Green Lavender Gray INAPPROPRIATE UNACCEPTABLE SPECIMENS 1 Hemolysis Occurs when erythrocytes are ruptured releasing their contents into the serum or plasma portion of the blood The slightest degree of hemolysis will affect many test results particularly potassium PT INR and a PTT Hemolysis may occur with even the slightest trauma to the specimen Some examples include a Difficult phlebotomy b Small lumen needle used to obtain specimens c Placing red top tubes immediately in the refrigerator without allowing 30 45 minutes at room temperature for complete clotting d Vigorous shaking of antic

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