MLS 201 Specimen Collection PDF

MLS 201 SPECIMEN COLLECTION  Introduction ❖ Accurate and quality lab results begins with accurate and complete sample collection. ❖ Proper collection, preparation, processing and preservation of the specimen is essential for obtaining best results ❖ Phle...

MLS 201 SPECIMEN COLLECTION  Introduction ❖ Accurate and quality lab results begins with accurate and complete sample collection. ❖ Proper collection, preparation, processing and preservation of the specimen is essential for obtaining best results ❖ Phlebotomist: Healthcare professional who has been trained to collect client’s blood specimen  Specimen types ❑ Random specimen: collected any time ❑ Fasting specimen: collected after no food has been eating for about 6-12 hrs and usually in the morning ❑ Timed specimen: collected at a particular time after an event such as eating or taking a medication, e.g 2HPP  Types of blood collection ✓ Capillary blood ▪ Blood collection from the finger or heel using a lancet. Finger prick ▪ For small amount of samples ✓ Venipuncture ▪ Blood collection from the Heel stick vein ▪ Most frequently used. ▪ Large amount of samples Veni-puncture ✓ Others: femoral tap ▪ using the femoral artery below the inguinal ligament Femoral tap  Preparation for blood collection ❖ The following should be done as Pre-collection procedures for all types of blood draw: ✓ Introduction ✓ patient identification using request form ✓ Discuss patient right ✓ Equipment/supplies selection ✓ Universal precautions ❖ Approach the patient in a friendly & calm manner. ❖ Provide for their comfort as much as possible. ❖ Briefly explain the procedure to the patient and assure him/her. ❖ Gain the patient’s cooperation before going ahead.  Patient rights The patient has the right to; Considerate and respectful care. Privacy & confidentiality Know the identity and professional status of the phlebotomist. Know if his/her sample would be used for research and refuse or accept participation. Refuse treatment to the extent permitted by law. Be informed of the hospital rules and regulations regarding patient conduct. Fundamental human right – Right to dignity of human person. No person shall be subjected to inhuman or degrading treatment. (Section 34, subsection 1,1999 constitution of FRN  Equipment selection ▪ Personal Protective Equipment (PPE) Laboratory coats Hand Gloves Eye goggles Face shields Covered toe shoes ▪ Appropriate specimen container ▪ Tourniquet: Constrictive band, placed over an extremity to distend veins ▪ Alcohol wipe ▪ Gauze/cotton balls ▪ Sharps container & biohazard bag ▪ Marker/Pen ▪ Needle and syringe  Universal precautions All specimen should be handled as if they are potentially infectious; ✓ Wear gloves and Lab coat when handling blood / body fluid ✓ Wear eye goggles & covered toe shoe ✓ No eating, drinking or smoking at the work station  Venipuncture ✓ Vein selection: select an appropriate vein for the procedure ✓ Avoid areas with: ❖ Extensive scars from burns and surgery. ❖ Intravenous therapy/ blood transfusion. Alternative sites for venipuncture Venipuncture procedure  Blood collection using finger prick 1. Position hand palm-side up. Choose 2. Apply intermittent pressure to whichever finger is least calloused. the finger to help the blood to flow 3. Clean the fingertip with alcohol. Start in 4. Hold the finger and firmly place a new the middle and work outward to prevent sterile lancet off-center on the fingertip contaminating the area. Allow the area to dry.  Blood collection using finger prick 5. Firmly press the lancet to puncture 6. Wipe away the first drop of blood the fingertip with a sterile gauze pad or cotton ball 7. Collect the specimen. Blood may 8. Apply a gauze pad or cotton ball to the flow best if the finger is held lower puncture site until the bleeding stops than the elbow.  Order of blood draw Collecting blood using multiple tubes  When multiple tubes are needed, the proper order of draw must be followed to avoid cross contamination and erroneous results.  The recommended order of draw include o Blood culture tube or bottle o Sodium citrate tube (blue closure) o Serum tubes, including those with clot activator and gels (gold closures) o Heparin tube with or without gel (dark green, light green, speckled green closures) o EDTA tube with or without gel separator (lavender, pearl, pink closures) o Sodium fluoride/potassium oxalate glycolytic inhibitor (gray closure)  Disposal k Properly dispose of all contaminated supplies Anticoagulants Anticoagulants Types of anticoagulants- Heparin EDTA- Ethylene Diamine Tetra-acetic Acid Oxalates Sodium fluoride Sodium citrate  Blood sample containers Plain containers: red cover Blood is allowed to clot after collection and separated to obtain serum EDTA containers ❖ Lavender/purple cover ❖ Used for haematological investigations ❑ However, there is need for proper sample preservation Specimen storage Specimen storage Disposal of specimens Sample reception and registration in the laboratory  Before a sample is taken/accepted in the lab verify patients name and identification number.  Always check whether the request format and the specimen which arrive in the laboratory are the same.  Verify the appropriateness of the sample container used and check the blood samples for clots  Registration  Give attention to urgent specimens.  Give more attention to the precious specimens.  Register all specimens on the log book with its laboratory reference number and reporting time as well as time of arrival. Registration includes:  All specimens must be registered and given number when they arrive at the laboratory and the results of all investigations must be recorded. This will:  avoid the risk of mixed up of specimen  Make possible to look up a result  Make the results available for the other staffs  Promote the public health  Help to trace the history of the patient  Help to trace back errors and avoids confusion in communication. Lab records  Numbering/labeling the specimens as soon as it is received.  Write the number immediately:  On the request form  On the specimen container  On every test tube used for the specimen  On every microscope slide used for the specimen  Standardization of lab reports contributes to efficiency of lab service and have a great value when patients are referred from one to an other.  A record of all test result must be kept by lab as carbon copies, work sheet or simple registration book.  Records of test are also required for preparing work report and estimating work load of the lab.  Lab records  Lab registration book should include:  date  name of the patient  lab ID number  age  sex  address  type of specimen collected  the result of each test  Each specimen should be numbered and recorded in the register  Importance of lab registration The Monthly Report  At the end of every month the lab. should submit its monthly report to the head of the institute. It helps to keep a check on the laboratory activities It is useful for public health surveillance. To keep track of samples received and results released  Specimen Rejection Criteria ✓ Specimen improperly labeled or unlabeled ✓ Specimen improperly collected or preserved ✓ Improperly completed request form ✓ Haemolyzed or clotted samples ✓ Lipemic samples