General Sample Guidelines can be downloaded here.

• Do not send specimens in non-sterile containers.
• Specimens should be obtained before antimicrobial agents have been administered.               
• An adequate quantity of material should be obtained for complete examination.  Always send pus rather than a swab of pus.
• The specimen taken should be representative of the disease process.  For example, material swabbed from the opening of a sinus tract is more likely to yield commensal micro-organisms on the skin than would material obtained by curettage or biopsy of the base of the tract.
• Care must be taken to avoid contamination of the specimen by micro-organisms normally found on the skin and mucous membranes.  Sterile equipment and aseptic technique must be used for collecting specimens, particularly for those from normally sterile sites.
• Specimens (other than blood cultures) should be stored at 2-8°C if immediate transportation to the laboratory is not possible. Fastidious organisms may not survive prolonged storage or may be overgrown by less fastidious organisms before culturing.
• Specimens may not be suitable for testing if they are so inadequately labelled that the patient’s identification is in doubt, or if they have leaked or been contaminated. In certain circumstances every effort is made to inform the requesting doctor first.
• Please contact the laboratory if there is any doubt about the best specimen to take or concerning the availability of a test.

A guide to changing internet explorer margins for all ICE forms can be downloaded here

 Specimens and request forms are checked on receipt to confirm the patient identification (PID) information provided on the form and specimen agree.  There are 4 PID data items; Surname, Forename, Date of Birth and ID Number (Hospital or NHS) which are required by the laboratory and these must match in order for the specimen to be accepted.  It is good practice for us to have location and date & time of sample collection. If errors are found the laboratory may contact the requestor, explain the problem and request a repeat specimen.

For samples that are not easily repeated (such as CSF or paediatric samples) the problem will first be discussed with a BMS from the relevant section who will make a decision on whether testing may be allowed to proceed (usually after discussion with the clinician concerned). If the specimen is tested the report will clearly state the nature of the problem as a comment. Alternatively, the requesting clinician will be asked to send a repeat sample.

For further details regarding incompletely labelled samples or forms please contact the laboratory.

Specimens are a potential source of infection and should be treated accordingly. Please fill all specimen bottles with the correct volume of blood to ensure correct anticoagulation, and all containers should be securely closed.  Leaking specimens with gross contamination of contents and containers are discarded. Pocket bags are available for specimen transport. NB: Form and specimen must not be in the same bag. Specimens should be placed in the appropriate container, which must be securely fastened. This must be placed in a clear plastic bag and sealed. Refer to local Trust policies. High Risk samples should be appropriately labelled on both the request form and specimen.  

The transport of samples from GP surgeries or other primary care locations is carried out by the Logistics service staff who will collect all samples from dedicated collection points. Specimens from within the hospital can be transported to Pathology either by the Pneumatic Tube System (PTS) if suitable, and/or by a porter. For urgent samples ward staff are required to arrange delivery to the laboratory. Specimens must first be placed in the plastic specimen bags together with the completed request form.

The best results are obtained when an appropriate, well taken specimen, in the proper container, is delivered to the laboratory promptly and relevant clinical information is provided on the request form. Delays can render the samples unusable, if immediate transportation to the laboratory is not possible blood specimens for microbiology/virology should be stored at 2-8°C, for biochemistry, haematology & immunology specimens should be stored at room temperature until transported to the laboratory.

The safe transport of specimens to the laboratory is the responsibility of the requesting doctor or carrier. Laboratory responsibility for the specimen begins when it has arrived at the laboratory. All samples delivered to laboratory reception from wards, in-patients, out-patient clinics and patients are carried to NNUH by a dedicated service, along with all GP ICE requests. 

The transport of samples from GP surgeries or other primary care locations is carried out by the Logistics service staff who will collect all samples from dedicated collection points. Samples from within the hospital can be transported to Pathology either by the Pneumatic Tube System (PTS) if suitable or by a porter.  For urgent samples ward staff are required to arrange delivery to the laboratory. Samples must first be placed in the plastic sample bags together with the completed request form.

The safe transport of specimens to the laboratory is the responsibility of the requesting doctor or carrier. Laboratory responsibility for the sample begins when it has arrived at the laboratory.

•     All items MUST be sent in the carriers provided.
•     Samples MUST not be placed directly into the carriers. ALL Pathology samples MUST be placed in specimen bags and the lids of all items with the potential to leak (fluids etc.) tightly secured BEFORE placing them in the carriers.
•     Do not cram samples/items into the carrier as this may lead to breakage/leakage and system failure.
•     Only one carrier at a time should be placed in a delivery station.
•     Ensure that carriers are closed securely at both ends to avoid them jamming in the tube network.
•     If any defect is noticed with the operation of the air-tube systems please notify the laboratory at the earliest opportunity.
•     The system must not be used for sending consumables and other “forbidden items” around the hospital.

The air tube systems are for the transport of Blood Sciences specimens to the laboratories only.

The air-tube system should NOT to be used for:

•     Danger of Infection samples
•     Blood gases
•     Blood cultures
•     Unrepeatable samples
•     CSFs (for culture, protein, glucose or xanthochromia)

SEE INDIVIDUAL TRUST POLICIES.

During normal working hours:

• Urgent samples from JPUH and QEH are sent to Blood Sciences for transporting to Microbiology.
• Non-urgent specimens from NNUH should be taken/sent to Pathology Reception, East Block, Level 1, Norfolk and Norwich University Hospital; these will be delivered by routine van runs to the EPA Microbiology Department.
•     Urgent specimens from NNUH should be taken to the Security desk at the West Atrium for delivery to the EPA Microbiology Department.  The EPA Microbiology Department must be contacted to ensure that the specimen is dealt with immediately.

Outside normal working hours:

• Non urgent samples from JPUH and QEH are sent to Blood Sciences for transporting to Microbiology.
• Non urgent specimens from NNUH should be taken/sent to Pathology Reception, East Block, Level 1, Norfolk and Norwich University Hospital, for delivery the following day to the EPA Microbiology Department.

• Urgent samples from JPUH and QEH are sent to Blood Sciences for transporting to Microbiology.
•     Urgent specimens from NNUH should be sent to the Security desk at the West Atrium NOT Pathology and instructions given to send the specimen to the Microbiology Laboratory.  Remember the Microbiology service is provided from the Norwich Research Park, Colney.  The specimen will be sent to the Microbiology Department via the most appropriate available transport.

For more detailed information about out of hours specimens click here

Medical officers responsible for the care of patients have a duty of care towards other members of staff – therefore all samples from patients who are known to have, or strongly suspected of having the conditions noted below must be identified.

•     Creutzfeldt – Jakob disease
•     Viral haemorrhagic fever (VHF) of any type
•     Microorganisms, (biological agents) in Hazard Group 3 or 4.
•     Pyrexia of unknown origin (PUO) recently returned from Africa.

Medical staff should ensure that appropriate information, including relevant travel history, is provided in order to alert laboratory staff of potential dangers. Clinical details supplied on sample 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 sample 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.

Successful diagnostic virology depends upon the correct timing and selection of clinical specimens and their collection and transport to the laboratory under appropriate conditions. Often the same clinical syndrome can be produced by a variety of viral agents and clinical differentiation of the specific infecting virus may be difficult if not impossible. Generally viruses are shed for only a few days before and after the onset of symptoms and therefore specimens for viral detection should be taken as early as possible in the illness.

Many viral infections are asymptomatic and some viruses may be excreted intermittently from various sites for prolonged periods of time. When a viral infection is diagnosed, either by virus detection or serologically, its significance and relevance to the illness under investigation can be determined only by careful consideration of the clinical picture.

If in doubt please contact the Duty Virologist during normal working hours or the on-call Consultant Virologist out of hours, if urgent.

Significant results are telephoned where clinically indicated.

Many tests can be processed urgently if clinically indicated, and after discussion with Duty Virologist.

Results of urgent requests and results which may aid immediate patient management will be telephoned.  This includes all positive blood cultures and CSFs.

In the event that the laboratory is unable to deliver the required service, e.g. due to equipment failure we will endeavour to contact all relevant users

For detailed information about out of hours specimens click here