Transcript Specimens: safe handling and transport

Oxford Radcliffe Hospitals
NHS Trust
Specimens: Safe Handling and Transport
This Poster provides guidance for Managers and Staff on the safe handling and transport of pathology specimens sent from all locations to Trust laboratories.
WARNING! Specimens received unlabelled, without a completed request card attached, in incorrect containers, with discrepancies or leaking are unlikely to be processed.
Please ask the specific laboratory or read the laboratory handbooks on the Clinical Intranet for information if in doubt.
Wear appropriate personal protective equipment (PPE)
Examples of PPE include:
Gloves
Goggles
Respirator
Apron/Gown
Identify the patient and the tests required, and use the correct pathology request card(s) for the test(s). Examples:
Dealing with spillages & leakages
Always wear PPE prior to clean up spillages and
discard PPE after use.
Blood grouping & Transfusion
Microbiology, Serology & Virology
Separate form for MRSA
screening
Immunology
Cellular Pathology
Separate forms for Histology, Cytology
and Neuropathology. Check on Clinical
intranet
 Never use a mixture of
disinfectants to clean a spill.
Clinical Biochemistry &
Laboratory Haematology
detergents
and
Inform other people within the department/ward
of the spillage and what has been spilt.
Histological Specimens
Small Spills (<2.5L)
Large Spills (2.5L or more)
Wipe up with De-formalizer pad, and then discard it
into a yellow bag for incineration.
OR
Cover with Formalin control granules for 15
minutes, then scrape up and discard into a clear
plastic bag. Label the bag ‘Inert mass of ureaformaldehyde. Non-hazardous waste’.
May require drastic measures i.e.:
Temporary evacuation of the area and involvement of
the Emergency Services.
If the spill is >2.5litres or if the area where the spillage
occurred is small/poorly ventilated, the Fire Brigade
should be notified immediately.
Biological Specimens (Body fluids)
Non-blood-stained Spills
Small & Large Spills
Use the correct and sterile container(s) for different test(s) before sampling
Examples:
Blood/Blood-stained Spills
Small Spills
1.Use paper towel to soak up spill, and then discard into a
yellow bag for incineration.
2.Clean contaminated area with detergent and hot water,
and then discard into a yellow bag for incineration.
Large Spills
1.Use paper towel to soak up spill, and then discard into 1. Cover spill with chlorine releasing granules
a yellow bag for incineration.
for 5 minutes.
2.Clean contaminated area with strong detergent
2. Clean contaminated area with detergent and
hypochlorite (1%) solution.
hot water, and then discard into a yellow bag
for incineration.
Blood-stained/non-blood-stained urine – Never use chlorine releasing agents to clean up the spillage because the resultant fume is a hazard!
Vacuum tubes
Charcoal swab
(Remember to check the order of
collection of tubes)
25ml plastic universal
Blood culture bottles
(For more information on other types of containers, please refer to the laboratories’ handbooks on ‘Clinical Intranet’)
Please ensure the following points are checked before packaging
Match the patient’s details on the request card and specimen container with the patient
Label the request card and the specimen container correctly, accurately and legibly
● NAME
● DATE OF BIRTH
● SEX
● NHS NUMBER (10 DIGITS)
● HOSP. NUMBER (7 DIGITS)
● LOCATION
● PHYSICIAN’S NAME
● TYPE OF SPECIMEN
● CLINICAL DETAILS
● TEST(S) REQUIRED
● TIME OF COLLECTION
● NAME
● DATE OF BIRTH
● NHS NUMBER (10 DIGITS)
● HOSP. NUMBER (7 DIGITS)
● TYPE OF SPECIMEN
● TIME OF COLLECTION
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● Is the lid of the specimen container sealed / tightened properly?
● Check for any leakages around the specimen container.
● Check the correct request card is used for the requested test (i.e. keep specimen(s) for microbiology separately
from biochemistry).
● State URGENT on the request card. If necessary inform the laboratory registrars and / or Biomedical Scientists.
● For interoperative specimens (i.e. frozen sections) and urgent fresh/unfixed biopsies - DO NOT place in formalin,
make sure they are package separately , deliver directly to cellular pathology and inform the laboratory.
Check there is no additional risk to laboratory staff if so label accordingly e.g. Danger of Infection (see below)
Collecting specimens from patients who have had a radioisotope should be avoided. Advice on specimen collection,
handling and transport for specimens with a Radioactive risk is available from Medical physics on extension
25441.
MATCH?
The standard packaging method
(For more information on packaging specimens for transport, please read the Trust policy on ‘Specimens: Safe Handling & Transport)
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Place the specimen container into the plastic bag attached to the request card and seal it properly.
(If multiple specimens are placed into the same bag, please cushion them to prevent breakage)
 For large specimen containers:
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Adhere the request card to the specimen container and make certain it will not fall off.
The bag of specimens can then be put together with other bags of specimens into a rigid
transport box.
(Place all specimens for one specific department into the same secondary bag i.e. all
microbiology specimens in one bag and immunology in another bag)
The Pod on the right hand side is for the Pneumatic (Air) System. A limited number of
specimens can be placed in it. Ensure specimen is well cushioned with absorbent material.
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(See
Infection
Control
Pneumatic (air) tube system Intranet Site for dealing with
spillages within the system)
Portering staff
There are four different transportation methods between hospital sites and to/from locations outside hospitals
Specimen must be double
bagged and the outside bag
clearly labeled ‘URGENT’
before placing in the transport
box. Please read the Packing
Instruction PI650 in appendix
D of ‘Safe Handling &
Transport Policy’.
Taxi
Royal Mail Group plc will not accept a package that contains UN2814 or UN2900
infectious substances/Category A infectious substances. They only accept
packages that contain Category B infectious substances that are packaged to
Packing Instruction PI650 in appendix D of ‘Safe Handling & Transport Policy’
requirements.
Post/Courier
Category A specimens need to be transported by specific couriers that meet 6.2
of the Technical Instructions for Safe Transport of Dangerous Goods by Air
published by ICAO. These specimens must be packaged and sent by trained
laboratory staff who have access to correct packaging and specialist Couriers.
Please contact the laboratory prior to sending Category A specimens.
It is the SCAS responsibility
to maintain a regular transport service and to ensure
specimen quality is not
compromised due to any
excessive delay.
South Central Ambulance
Service NHS Trust
(SCAS) non-patient
transport service
Web Links:
Porter’s desk extensions:
The following links can only be accessed within the hospitals’ computers.
National Health Service (NHS) – http://www.nhs.uk
• On the John Radcliffe Hospital site – 40404
• On Churchill Hospital site – 25024
• On Horton General Hospital site – 59000
Clinical Intranet:
Pathology Transport Bags & Packs – http://www.versapak.co.uk
• Microbiology Handbook - http://lmweb.oxnet.nhs.uk/labmed/micro/for_upload/index.htm
• Haematology Handbook - http://lmweb.oxnet.nhs.uk/labmed/hbk/HOME003.HTM
• Immunology Handbook - http://lmweb.oxnet.nhs.uk/labmed/hbk/imm/immunology.htm
• Cellular Pathology Handbook - http://orhnet.orh.nhs.uk/cellpath/link.asp?pid=0&id=1464
• Biochemistry Handbook - http://lmweb.oxnet.nhs.uk/labmed/hbk/HOME001.HTM
Pathology Specimen Transport Packaging – http://www.dgpgroup.com
• Biochemistry – 018652 20336
• Cytology – 018652 20509
• Haematology – 018652 20336
• Histology – 018652 20490/20491
• Immunology – 018652 25995
• Microbiology – 018652 21918
• Virology – 018652 20877
(For more information on and the name of other hazardous pathogens, please refer to the ‘Specimens: Safe Handling & Transport Policy’
appendix C for category A organisms, and the ‘Advisory Committee on Dangerous Pathogens’ for pathogen hazard groups
http://www.dh.gov.uk/ab/ACDP/DH_087526)
Depending on the size of the specimen container used. If it is too large it may not fit
securely into a rigid transport box together with other specimens. The specimen
container will need to be placed into another transport box on its own. Ensure the
specimen is well cushioned with absorbent material.
Taxis are used for URGENT
specimens outside the normal
working hours of SCAS transport services.
Contact Numbers:
Laboratory telephone numbers:
Some Examples: Hepatitis B virus and Hepatitis C virus, Human immunodeficiency virus (HIV), Creutzfeldt-Jakob
Disease (CJD), Brucella spp., Mycobacterium tuberculosis (TB), Salmonella typhi (Typhoid) and Salmonella
paratyphi, Escherichia coli O157, Taenia solium, Histoplasma capsulatum.
If the specimen container is too large to fit into a transparent plastic bag, please use a
larger plastic bag to contain it. Do not send without a secondary plastic bag.
Please use the portering service in the event
of a breakdown or for
any
specimens not
suitable for transport by
the pneumatic (air) tube
system.
(See Estates & Facilities
Intranet Site for the Standard
Operating Procedures)
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There are two main methods of transportation within the hospital
Highly reliable system that
allows rapid transport of
specimens from wards to
laboratories.
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Specimens are then placed into a second, large, transparent plastic bag. Please add
sufficient absorbent material to absorb any fluid in case of breakage.
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Label request card and specimen with the ‘Danger of Infection’ Sticker if the patient is known or suspected to have
hazard group 3 or group 4 pathogen(s) and state on the request card the risk.
Infection Control Intranet site - http://orh.oxnet.nhs.uk/InfectionControl/Pages/Default.aspx
Estates & Facilities Intranet site - http://orh.oxnet.nhs.uk/Estates/Pages/Default.aspx
Safety Pack – http://www.saftpack.com
A patient may take their
own
specimen(s) to laboratory via public
transport as this is outside the “The
Carriage of Dangerous Goods and
Use of Transportable Pressure
Equipment
Regulations
2004
(‘Carriage Regulations’)”.
Public Transport
A member of staff transporting clinical
specimens via public transport as
part of their work must comply with
the ‘Carriage Regulations’.
References:
Health & Safety at Work Act 1974.
The Management of Health & Safety at Work Regulations 1999.
The Carriage of Dangerous Goods and Use of Transportable Pressure Equipment Regulations 2004 ('Carriage Regulations').
Royal Mail – http://www.royalmail.com
The Control of Substances Hazardous to Health (COSHH) Regulations 2004.
Health & Safety Executive (HSE) – http://www.hse.gov.uk
“Working with ADR: An Introduction to the Carriage of Dangerous Goods by Road” (Department of Transport 2005) - ISBN 1904763-47-2.
Health Protection Agency (HPA) – http://www.hpa.org.uk
World Health Organisation (WHO) – http://www.who.int
Patient Sample and Request Form Identification Criteria (Institute of Biomedical Science).
Dangerous Goods Regulation (DGR) & International Air Transport Association (IATA) – http://www.iata.org/cargo/dg
Transport of Infectious Substances – Best Practice Guidance for Microbiology Laboratories (Department of Health - June 2007).
South Central Ambulance Serivce NHS Trust (SCAT) – http://www.southcentralambulance.nhs.uk
Transport of Infectious Substances (Department of Health – Revision 3 – November 2006).
Advisory Committee on Dangerous Pathogens (ADCP) – http://www.dh.gov.uk/ab/ACDP/index.htm
Infection at Work: Controlling the Risks (Advisory Committee on Dangerous Pathogens – 2003).
Safe Handling and Transport Version 1: Date Issued 22nd September 2010